Application form for A New Theme for New Horizons

Please complete this form and return to bca@bca.org.au by Monday, 16 November 2015

Personal Details:
Name:
Address:
Phone:
Mobile Phone:
E-mail:

About Your Entry:
Are you entering as an individual or as a group?
Title of Song:
Who wrote the music? 
Who wrote the lyrics?

Declaration:
By signing this form, you agree that:
You have read and agree to the conditions of entry at www.bca.org.au
You are submitting an original work for which you hold the copyright
You have sent an MP3 file and a copy of the lyrics of your song to bca@bca.org.au

Signature:
Date: