KYOU Caring Connection

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Area CodePhone Number

Non-Profit Organization's 503c Number

Name of Organization*

If you are looking for general promotion for your non-profit organization, and not event promotion, give a brief description of the goals of your promotion (i.e. message, intended results, target audience, etc.)

Answer the event-related questions below If your organization is looking for promotion for an event, otherwise leave them blank

Name of Event

Description of Event

Date and Start Time of Event

DateHourMinutesAM/PM Option

Location of Event

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Website/Social Media

Who will benefit from the event?

Expected number of participants (goal)

Is the event open to the public?

YesNo

Is there a cost to participate?

YesNo

Expected funds raised after expenses?

How will the funds be used? (How much stays local, how much for admin costs, etc.)

Expected expenses (venue rental, supplies, etc.)

Geographic influences of event

What other media does the event have or expect?

Will your event feature a media emcee or local talent/judge?

YesNo

If you answered 'Yes' above, who will be the media emcee or local talent/judge?

If you wish to request a KYOU-TV personality to emcee or judge, what would be the responsibilities and approximate time commitment (including pre-event meetings)

Please enter your date of birth.*

You must be at least 18 years of age to submit this form.

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