PROGRAM HOST APPLICATION

Date

MonthDayYear
PROGRAM HOST APPLICATION

Help us know your show better.
Name*
Ex: Joe Dough
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*

PROGRAMMING INFORMATION:
PROGRAMMING INFORMATION:
Name of Show*
Type of Show *
Ex: Music,Talk
Length of Show*
Ex; 1hr,2hr, 3hr
PROGRAMMING SOCIAL LINKS:*
DESCRIPTION of SHOW:*

PREFERRED TIME SLOT(s):
PREFERRED TIME SLOT(s)
First Choice *
Mon / 6pm
Second Choice *
Sun / 2 PM
Third Choice
Thur 11 am

AVAILABILITY
AVAILABILITY

During which hours are you available for meetings and assignment.
Check Whats Best

Weekday MorningsWeekend MorningsWeekday AfternoonsWeekend AfternoonsWeekday EveningsWeekend Evenings