Music Submission Form

Who referred you?*

Please ask your rep what their name is...

Artist Real Govt name*

First NameLast Name

Artist Stage Name*

Instagram Username*

E-mail

example@example.com

Phone Number*

Please enter a valid phone number.

Which option did you need?

Song played on All Playlist $199The Shorty Roc NYC Radio Show (Mon-Fri 2pm -6pm EST)We Run The City Radio (Sat & Sun 4pm -8pm EST)Elevate Your Growth Radio (Every day 10am - 2pm EST)Grow Your Business Radio (Every day 5am - 10am EST)The Girls Night Out Radio Show (Sat & Sun 8pm -12am EST)Truth or Dare Radio (Sat & Sun 12am - 4am)Pretty Goons Radio

Track Name*

Producer Name

Upload Music*

My Products

2 Month of Radio PlayAdd your song to our playlist for 60 Days of play per song per month. To cancel Contact gde4life@gmail.com

$60.00

3 Months of Radio PlayGet 3 Months of Radio Play. To cancel Contact gde4life@gmail.com

$90.00

6 Months of Radio PlayTo cancel Contact gde4life@gmail.com

$180.00

12 Months of Radio PlaySave $60 when you purchase 12 months of Radio Play. To cancel Contact gde4life@gmail.com

$300.00

Song played on ALL Playlist for 30 Days Product Image

Song played on ALL Playlist for 30 DaysYour Song will be played on ALL our Radio Playlist for 30 Days. To cancel contact gde4life@gmail.com

$199.00

Custom OrderThis section can only be chosen when there are multiple songs are uploaded and/or custom price is negotiated by The Khaliseum Radio Network

$ Free

Total

$0.00

By submitting this song, the submitter hereby represents and warrants that they possess full legal authority to act on behalf of the artist, that they are the rightful owner of all rights associated with the submitted song, and that they hereby grant The Khaliseum Radio Network irrevocable and unrestricted permission to include, broadcast, and reproduce the song on the network's radio station playlist. The submitter further agrees to indemnify and hold harmless The Khaliseum Radio Network from any claims, damages, or liabilities arising out of any breach of this representation and warranty.

**Subscription Payment Notice**

Thank you for choosing our services! Please note that the price you select is a recurring fee. This amount will be automatically charged to the card you provide, on a regular basis, based on your subscription term. You will see this charge reflected on your card statement for each renewal period unless you cancel 30 days before the next billing cycle.

If you have any questions or wish to modify your subscription, please contact us at gde4life@gmail.com

Thank you for your understanding and support!

Signature*

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Submit Your Music