Submit your act for DVERS 2019!
Below you find the application form for DVERS 2019, which will take place on Saturday the 28th of September, in the city centre of Sittard (NL). DVERS is organised by the organisation Pop in Limburg.

Fill in the complete form and make sure you send us two music tracks, by uploading them to the link given at the end of this form.

You can sign up for DVERS 2019 until Sunday the 16th of June, 2019.
The selection for DVERS 2019 will be anounced in the week of July 22, 2019.

If you have any questions, please send an email to jesse@popinlimburg.nl or telephone +31(0)46 202 1360. Good luck!

Act information
Name of your act: *
Your answer
Genre: *
Your answer
Number of people playing in the act: *
Your answer
Posting (standplaats/Standplatz). Write down a city name: *
Your answer
Social media: *
Your answer
Website:
Your answer
Contact information
Contact surname: *
Your answer
Surname prefix:
Your answer
Contact first name: *
Your answer
Adress: *
Street and number
Your answer
Postal code: *
Your answer
City: *
Your answer
Country: *
Your answer
E-mail adress: *
Your answer
Mobile number: *
Your answer
Privacy
According to the General Data Protection Regulation we want to ask you a few questions to make sure your privacy preferences are guaranteed.

Your choices can always be changed later on, by sending us an e-mail. For more information, you can visit our Pop in Limburg website to read about our privacy policy: www.popinlimburg.nl/privacy/

I grant the Pop in Limburg organisation permission to write my name (and/or the name of my musical act), if need be, on a selection list.
I grant the Pop in Limburg organisation permission, if need be, to publish my participation.
I grant the Pop in Limburg organisation permission to make pictures of me and my musical act, if need be.
I grant the Pop in Limburg organisation permission, if need be, to publish pictures of me and my musical act on their website, social media, and such.
Foto: Sharik Derksen
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