D A F
Family Health Radio - Distribution Agreement Form (PDF version)

Please fill out this form completely to receive the Family Health series for your station. It is offered free, as a public service.

For “Group” stations please include the calls/frequency and city of license in the comments section.
Call Letters:
Frequency:
Band:
Address:
City:
State:
Zip Code:
   
City Of License:
Telephone:
Fax:
   
Your First Name:
Your Last Name:
Title:
Your email Address:
Station Web Site: http://
   
Wattage:
Format:
Coverage Area Population:
Station Audience Size: (Average Qtr. Hr.)
   
Method of Distribution:

CD Shipped
- OR -
Download MP3 files from web

Schedule: Mon - Fri Assumed
Sponsor | Underwriter:
   
Subject:

Your comments:

You must fill in the fields marked with an *
If you have not received the latest CD and can download MP3 audio files, click here to get the current programs.