APPLICATION FORM

For your convenience, this application is digital and can be filled out on your computer/device.

PERSONAL INFORMATION

Please provide the number of the applicant filling out this application.

CONTACT INFORMATION

Please provide the full name of the person of contact regarding your application if different than the contact listed in the PERSONAL INFORMATION area.

TIME SLOTS: TV Broadcasts + Infomercials

Please indicate your preferred time slot(s) if applying for TV Broadcasts or Infomercials:

Please include the day of the week + time of the day that you'd like to indicate as your preferred time slots. EX: Every Sunday at 9:00am.
Please include the day of the week + time of the day that you'd like to indicate as your preferred time slots. EX: Every Sunday at 9:00am.
Please include the day of the week + time of the day that you'd like to indicate as your preferred time slots. EX: Every Sunday at 9:00am.

TIME SLOTS: Commercials

Please indicate any specific day, time or broadcast that you would like your ads to air during:

Please include the day of the week + time of the day that you'd like to indicate as your preferred time slots. EX: Every Sunday at 9:00am.
Please include the day of the week + time of the day that you'd like to indicate as your preferred time slots. EX: Every Sunday at 9:00am.
Please include the day of the week + time of the day that you'd like to indicate as your preferred time slots. EX: Every Sunday at 9:00am.

We will do our best to accommodate your preferences. However, be advised that time slots are given in order of applications received.
NOTE: All time slots inquiries are in reference to EST Time Zone.

Programming Choice
Programming Frequency - If TV Broadcast
Programming Frequency - If Infomercial

If you selected "Other" as your Programming Choice, please explain below:

MINISTRY/BUSINESS INFORMATION

Please provide the name of the primary organization that will be displayed on your broadcasted content.
Please provide the physical address of the ministry. Leave blank if ministry/business is not conducted within a commercial property.
Please check the box indicating you acknowledge that all information you entered is accurate. *
THANK YOU FOR YOUR APPLICATION. We will contact you within 1-2 business days.
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