Underwriting Contract Online payments accepted through PayPal. "*" indicates required fields Organization InfoName of Organization* Contact Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Website Package and ContentAnnouncement*Use the space below to draft a 15-20 second description of your organization. The actual verbiage of the on-air announcement will be adjusted by our underwriting committee to comply with FCC guidelines and resubmitted to you for final approval before recording. Please allow one week after processing to hear your announcement on the air. Package Fee Contract Length Versions Cost Per Spot* Basic One $175 6 months 1 version $0.48 Basic Two $300 12 months 1 version $0.41 Premium One $400 12 months 2 versions $0.55 Premium Two $600 12 months 4 versions $0.82 *ApproximateSelect Package* Basic One - $175 Basic Two - $300 Premium One - $400 Premium Two - $600 All packages will air your announcement twice per day between 6am and 6pm, 7 days a week for the duration of the contract.Proposed Start Date MM slash DD slash YYYY Package Total Upon submission of this form, you will be redirected to PayPal for payment of this amount.Select Payment Method* Pay online with PayPal or credit card Pay by mail with a check Payment MethodPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Signature* Reset signature Signature locked. Reset to sign again CAPTCHA