* required
Name *
Address *
City/Town *
Phone *
Alternate Phone
Email *
Co-host Name
Co-host Phone
Co-host Alternate Phone
Co-host Email
Does your co-host operate the board? -- Yes No
Have you completed 6 volunteer service hours since the start of the last term? * -- Yes No
Program Title *
My program currently runs - Choose - Monthly Bi-weekly Weekly Other
Day of the week - Choose - Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays Any Weekday Any Weekend Day Other
For How Long? - Choose - An hour A half hour Less than a half hour" More than an hour
How often do you pre-record your program?
Does this arrangement/time slot work for you? * yes no
Please complete this section even if you adore your current time slot. Please note that the 5-6:30pm programming block is reserved for the syndicated news programs Free Speech Radio News and Democracy Now!, and is not available for other programming.
Are you requesting any scheduling changes for your program? If yes, what? *
If my program is moved, my first choice * frequency: day: time: length:
Second choice * frequency: day: time: length:
Third choice * frequency: day: time: length:
Comments on schedule placement
Have you reviewed the description in the program guide or the one on the website lately? Are there corrections that should be made? Please let us know here
Upon submission, you will receive a copy of your application via email. If you do not receive a copy, email .(JavaScript must be enabled to view this email address) to make sure your application was received.