STAR TEAM MEMBER APPLICATION

Please Print and fill out this application completely:

 Name:                                                                                                                                                   
               Please Print First / Middle and Last Name /  Notice:  If you are under 13 years of age,

           Parent must sign below, giving there permission!

 Parent or legal guardian: I                                                                                                                  

         Hereby give my permission for the above named to become
          a STAR TEAM MEMBER of  Teddy Berge Enterprises

 E-Mail Address of parent or legal guardian: _________________________________________
 Address:                                                                                                                                             

                    Please Print

 City:                                                                         State:                                          
 Zip:                            
 Date of Birth: Month             Day                Year                     (Must be at least 13 years of age!)  (Please read rules below)

              Please Print

 E-Mail Address:                                                               Home Phone No.                                                

              Please Print

 Cell Phone:                                                               (Optional)

 What Capacity Would you Prefer?  Please  Check all that you prefer:
 RADIO PROMOTION?         

 This consists of calling radio stations, requesting Teddy's music and setting up interviews.

 
 CD RETAIL PROMOTION?        

 This consists of selling or setting up merchant retail in your area.

 PUBLICITY PROMOTION?         

 This consists of contacting magazines, newspapers, writing interviews or
 anything to do with the promotion or publicity of Teddy Berge and of Teddy's music.

 Missions?         

 This consists of distributing stickers or flyers and hanging up posters.

 Once your application is processed , you will receive your

 STAR TEAM MEMBER-NUMBER to use when corresponding with

 Teddy Berge Enterprises.

 For more information on becoming a STAR-TEAM MEMBER,
 please write Teddy Berge Enterprises at:

 Teddy Berge EnterprisesP.O. Box 21255 Keizer, Oregon 97303 or E-Mail:  teddyberge@teddyberge.com