Deezer Membership Competition
Questions marked by * are required.
1.	Forename: *
2.	Surname: *
3.	Address 1: *
4.	Address 2:
5.	Town: *
6.	Postcode/Zipcode: *
7.	Country: *
8.	Email: *
9.	Are you a subscriber? Yes No
10.	Would you like your details included in third party mailings? Yes No