*
Name:
(First & Last)
Address Line 1:
Address Line 2:
(Apt, Lot, Suite, etc.)
*
City:
State / Province:
-
IN
OH
MI
IL
TN
KY
WI
PA
Zip/Postal Code:
Work Phone:
(000-000-0000)
Home Phone:
(000-000-0000)
Cell Phone:
(000-000-0000)
*
Best Number To Reach You:
-
Home
Work
Cell
(Choose One)
*
E-Mail:
Age:
(Must be 18 and have a High School Diploma or GED)
Sex:
Male:
Female:
Current Occupation:
When would you like to start?
(MM/YYYY)
*
These fields are required.
Level of education completed:
High School
Some College
College
Graduate School
Seminary/Vocational/Trade School
Do you have any paid broadcasting experience? If so, please explain:
Do you have any academic, volunteer or unpaid broadcasting experience? If so, please explain:
List the city or cities where you would like to train:
How did you hear about us?
Click on submit when you have completed the preliminary application