Derptech Registration Form

Derptech Registration Form
Name*

First NameLast Name
Birth date

MonthDayYear
E-mail*
What is your Discord tag?*
name#1234
Why do you want to be apart of the team?*
What is your talents, and what can you do to contribute to the team?*
Which role to the team would you like to take?

ComposerWriterProgrammerArtistDesignerModelerOther
Enter the message as it's shown*
Should be Empty: