Please note: all fields are mandatory. Enter "n/a" if a field doesn't apply. Direct any questions to Promotion.

Who are ya?

What's your e-mail address?

For which station is this request?

Is this request for on-air, digital, or both?

Part I — Promotion Request Summary

Client name

Contact name

Contact phone number

Client's product or service

How much this client has invested with us year-to-date [ON-AIR]

$

How much this client has invested with us year-to-date [DIGITAL]

$

What is the advertising buy attached to this promo [ON-AIR]?

$

What is the advertising buy attached to this promo [DIGITAL]?

$

What, specifically, is the client's promotional objectives or expectations?

What specifically is the prizing involved to successfully execute this event (quality and value)?

Timeframe of Promotion

Starting

Ending

Exact date (or dates) of promotion

Has your client approached other media for this Promotion?

If this request includes digital, please include details here. (Optional)

Any other notes to add to this request? (Optional)

Date of your next meeting with client

Part II — What will the Client provide?

On-air spot schedule

Cash amount of this buy

$

Digital campaign

Cash amount of this buy directed to digital

$

Prizes

Retail value of prizes provided by client

$

Talent or setup fee

Cash to cover hard costs

$

Other cash or promo value

Other benefits not listed above

$

Total benefits

$