WVLT VOLUNTEER TV PUBLIC SERVICE ANNOUNCEMENT REQUEST FORM

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1.Requested Information
Organization*
Event*
Date of Event*
2.Is This Event Not-For-Profit?*
Yes
No
501-C3
3.If this is a charitable organization, who will benefit from this event?
4.Is advertising being purchased for this event from other media outlets?*
Yes
No
5.If yes, please list other outlets:
6.Please give a brief description of the event below:*
7.Contact Person
*
8.Phone Number
*
9.Email
*
10.Will WVLT need to share PSA with other media?*
Yes
No
11.Please list who:
12.Please enter your date of birth.
Month* Day* Year*
13.Terms and Conditions
I have read, understand, and agree to the Website usage agreement and privacy policy.
* represents required fields

WVLT VOLUNTEER TV

6450 Papermill Drive Knoxville, TN 37919 Phone - (865) 450-8888; Fax - (865) 450-8869
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