Promotion Request Form
Name
*
First Name
Last Name
E-mail
*
Today's Date
*
-
Month
-
Day
Year
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New/Sold?
Please Select
New - Request for Proposal
Sold - Request for Implementation
Renew - Request for Renewal
Station(s)
WHEB-FM
WTBU-FM
WGIR-FM
WGIR-AM
WQSO-FM
WPKX-AM
WERZ-FM
Client
*
Client Location
Client Investment
Type Of Promotion
Promotional Request
Remote/Live Broadcast
Client Giveaway
Endorsement
Feature Sponsorship
Interview
Presale
Presale Code
Presale Link
Event Date
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Month
-
Day
Year
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Event Time
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12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
until
until
1
2
3
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5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Talent Requested
Talent Fee Amount
Talent Fee Invoiced
YES
NO
AE Working Event
First Name
Last Name
Live Call Backs
YES
NO
Aircheck Needed
YES
NO
Promotion Plan
Including Contesting Methodology
Special Instructions
Submit
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