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Please complete the form below and click SUBMIT.  This is NOT a contract; only the first step.  Please also review our SAMPLE AGREEMENT which can be modified to meet your needs.

We look forward to hearing from you.

Your Name *

Your Position: * (To Select More Than 1, Hold Down Control Key)

Your Email *

Your DIRECT Station Phone Number: * (XXX-XXX-XXXX)

Your Cell Phone Number: (XXX-XXX-XXXX)

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Station Call Letters and Location; City/State: *

Your Timeframe For Fiinalizing Placement(s): *
ASAPNext 3 MonthsNext 6 MonthsNext 9 MonthsNext Year

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