Contact Info:

1. First Name:
2. Last Name:
3. Email:
4. Phone:
5. Address:
6. Address 2:
7. City:
8. State: Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
9. Zip:

Artist/Educator Info:

1. Artist/Group Name: (if applicable)
2. Management: (if applicable)
3. Record Label: (if applicable)
4. School or University: (if applicable)
5. Website:
6. MySpace:
7. Facebook:
8. Twitter:
9. YouTube:
10. Check any of the following that apply:
    • Touring Musician
    • Studio Musician
    • Worship Musician
    • Producer
    • Musical Director
    • Solo Performer
    • Music Educator
    • Production Company
11. Enter the Roland products you are currently using:
12. Enter the Roland products you are inquiring about:

Subscriptions

1. We encourage you to subscribe to our online newsletters so that you can stay informed about the latest news, updates and events at Roland U.S., and learn about other music professionals that use our products:
   • Insider: The Roland U.S. bi-monthly email newsletter
   • All Access: The BOSS U.S. bi-monthly email newsletter
   • Worship Connection: Periodic newsletter for our Worship Arts community
   • Music Education: “The Educator”—newsletter for music educators
2. Please notify me about special Artist & Educators Alliance VIP events.
3. I have read and agree to the Terms & Conditions.