WJAY RADIO Shoutout Submission Form

WJAY RADIO Shoutout

SUBMISSION FORM
INSTRUCTIONS

Complete this form to be included in the Birthday and Anniversary Shoutouts on WJAY RADIO. Shoutouts air on Fridays. Submissions are not guaranteed to air.
Your Name*
Your Phone*
Your Email
example@example.com
Type of Shoutout*

BirthdayAnniversaryBoth
Birthday Shoutouts
I would like to wish a Happy Birthday to First Name* Last Name* .
Date of Birth (Example: 01/01/2021)*

MonthDayYear
Other Comments
Anniversary Shoutouts

Wedding Anniversary
I want to wish a Happy Wedding Anniversary to First Name* Last Name*.
Wedding Anniversary Date (Example: 01/01/2021)*

MonthDayYear
Other Comments
Should be Empty:

WJAY RADIO Shoutout