RADIO PROGRAM REQUEST FORM
Your Name: (first & last)
Mailing Address:
ADDRESS LINE 1:*
ADDRESS LINE 2:
CITY:* STATE:* ZIP CODE:*
PRIMARY PHONE: EXT: PHONE TYPE: choose HOME WORK MOBILE
ALTERNATE PHONE: EXT: PHONE TYPE: choose HOME WORK MOBILE
Your Email Address:
PLEASE PROVIDE THE DATE OF THE SUNDAY THAT YOU ARE REQUESTING A RECORDING FOR:
IF YOU DO NOT KNOW THE EXACT DATE OF THE SUNDAY, THEN PLEASE TRY TO PROVIDE THE MONTH, YEAR AND SERMON TOPIC OR IF YOU ARE REQUESTING A LESSON WITH A CERTAIN TOPIC PLEAS PROVIDE THAT BELOW:
Comments: \
PLEASE CHOOSE HOW MANY COPIES OF COMPACT DISC'S (CD'S) AND/OR CASSETTE TAPE'S YOU WOULD LIKE TO HAVE:
I WOULD LIKE COPIES OF THIS SERMON ON CD
I WOULD LIKE COPIES OF THIS SERMON ON CASSETTE TAPE