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Section 1: Your Personal Details

* Required Fields

Your Address

 

* Has your postal address changed since your last claim?

* Do you want APRA to confirm that we have received this form?

* Do you have any further evidence to accompany this submission?

*PLEASE NOTE:
TOUR SUPPORT PERFORMANCE/S (If applicable)
If any of the following dates are for performances where the performer/s were the support act for the headlining performer/s please complete the following:

Headline Performer:
Tour Name:
Performance Dates: From: - To:

Section 2: Venue details

Please take care to fill in ALL the fields in a row. Our current system does not allow us to validate this information. If there are insufficient fields for the amount of information you wish to enter, please submit this form multiple times.

* Date of Performance dd/mm/yyyy * Venue Name * Venue Address * Venue Country * Promoter's Name * Promoter's Contact No. * Promoter's Address

Section 3: Date of Performance

* Title of Work * Date
dd/mm/yyyy
Date
dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
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dd/mm/yyyy
 

PRIVACY NOTICE

The information you are providing may be personal information under the Privacy Act. Information collected is only for the business purposes of APRA and will not be disclosed to any third parties except in accordance with the privacy policy of APRA. The privacy policy can be obtained from APRA.

If this form appears incorrectly, refuses to submit or should you require any further assistance regarding this submission please contact:

Australian Members
Tony Kay
Writer Services Representative
Direct Tel: 02 9935 7743
Email: tkay@apra.com.au

New Zealand Members
Petrina George
Manager Member Services
Direct Tel: 09 623 4714
Email: pgeorge@apra.com.au