Underwriting Contract

Online payments accepted through PayPal.

"*" indicates required fields

Name of Organization*

Contact Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

Website

Announcement

A KLZR representative will contact you to work out the wording of your announcement.

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

*Approximate

Select 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

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 Method

American Express

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Card Number Expiration Date Security Code Cardholder Name

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