Step 1: Your Information (** required information) 
** First Name:
** Last Name:
**Job Title:
**Personal station e-mail address:

** Phone:
- - ext.
 (NOTE: Non-station addresses such as @hotmail not accepted)

Step 2: Your station Information
** Official Station Call Letters:
Station On-Air Name: (eg "The  Bear")
Station Format:
Station Address:
City:
Province:
Postal Code:
Station Phone:
- -