Email Address:

Birthdate:

Phone:

Can you receive Text Messages?

Home Mailing Address:

City: State: Zip Code:

School and Extracurricular Activites you participate in:

Why Do you want to be an Intern for Digital Xtreme Media:

What are your five favorite bands:

What are your five favorite movies:

Do you have any musical abilities, talent or experience?

Do you have any recording experience talent or experience?

Please list five words to describe yourself:

Please List your past Job/Work experience:

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