WCYB Request To Appear On News 5 At Noon

1. Your Name: *This question is required.

2. Your E-mail: *This question is required.

3. Phone Number: *This question is required.

4. What organization do you represent (if any)? *This question is required.

5. Dates, times, location of event: *This question is required.

6. Requested date for appearance: *This question is required.

7. Name and description of event: *This question is required.

8. Please list any contact information you wish to include (website, phone, email, etc.): *This question is required.

9. Please list all sponsors associated with your event (including all media).

10. Are you running any paid advertising? *This question is required.

11. If yes, with whom?

Thanks for taking time to fill out this form! We appreciate all your help.

Page One