KCTV5 Cares Charity Form
Non-profit/Organization Name
*
Official Name
*
Date of the Event
*
-
Month
-
Day
Year
Is this Date Confirmed?
*
Yes
No
Location of Event
*
Years in Existence
*
Last Attendance
*
Contact Name
*
First Name
Last Name
Title
*
Best Phone Number to Reach You At?
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Organization Website
*
Is Organization a 501c3?*
*
Yes
No
Federal Tax Number
*
Describe Event
*
List ALL Sponsors (Note Title or Presenting Sponsors)
*
List ALL Opportunities Available to KCTV5 and Take 5 for Branding (i.e. signage, booth space, print, radio, etc.)
*
Value of Branding Opportunities Available to KCTV5 and Take 5 to Care Sponsors:
*
Will KCTV5 be the "Exclusive" Media Partner?
*
Yes
No
Will KCTV5 be the “Exclusive” TV Partner?
*
Yes
No
Will You be Seeking Additional Media Sponsors (i.e. radio, print, cable, etc.)?
*
Yes
No
List Additional Media Partners (if applicable)
Will You be Seeking a KCTV5 Personality to Emcee?
*
Yes
No
List up to 3 On-Air Talent Names You Would Like for Possible Emcees
*
Do You have an Advertising Budget?
*
Yes
No
Total Advertising Budget for Event?
List all Outlets/Platforms in Which You Will be Promoting Your Event?
*
Any Additional Information You Would Like KCTV5 to Know About Your Event or Organization?
You have read Gray Local Media, Inc.'s Standard Terms and Conditions at https://graymedia.com/about/terms-of-use and agree to those terms in full.
*
Yes
Submit
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