Request to Produce Approved Copy

*Your Name:

*Your Email Address:

*Best Phone Number to Reach You:

*Station or Agency:

*Advertiser's Business Name:

*Co-op?:YesNo

Co-op Name:

*Copy Due Date:

Copy Start Date:

Copy End Date:

*Commercial Length::10 :15 :30 :60 Other:

Using Client's Jingle?:YesNo

Jingle donut length:

*Target Audience:MaleFemale

*Median Age Range/Target Demo:

Your Delivery Description:

Additional Details/Pronunciations:

Approved Copy:Please do not type everything in capital letters