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106LiveRadio.com Show Interest Form
This form is just a basic inquiry for submitting a show concept to the station. No ideas belong to Source of Wellness Media and we have no rights to anything in this form unless it is a contractual agreement. This is a confidential disclosure for our executive team and should be filled out prior to setting up a meeting.
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#team106 - Show Host for On-Air Personality (With :21 & :47 Commercial Breaks)
Audio Only Podcast Segment - 30 Mins (No Commercial Breaks)
Audio Only Podcast - 1 Hour (With :21 & :47 Commercial Breaks)
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Paid On-Air Personality Opportunities Are Available
Paid On-Air Personality Opportunities Are Available
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Full Legal Name
Full Legal Name
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Name of your program
Name of your program
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Host Name, Stage Name, Brand Name or Industry Name
Host Name, Stage Name, Brand Name or Industry Name
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Phone Number
Phone Number
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Email
Email
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Image - Horizontal Photo of yourself
Image - Horizontal Photo of yourself
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Start Date (Preferred Day)
Start Date (Preferred Day)
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Start Date (Preferred Time)
Start Date (Preferred Time)
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What's your main message?
What's your main message?
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Show Description
Show Description
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Target Audience & Ages
Target Audience & Ages
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Will you have a co-host(s)
Will you have a co-host(s)
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Yes
No
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Avaiable days to host (possible days)
Avaiable days to host (possible days)
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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Will you need a Board Operator Training to handle your own show or Will you be requesting a Board Operator from the station?
Will you need a Board Operator Training to handle your own show or Will you be requesting a Board Operator from the station?
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Yes ( $800 Board Op Fee)
No (One will be assigned based on show times)
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Instagram
Instagram
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LinkedIn Handle
LinkedIn Handle
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Facebook Handle
Facebook Handle
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Additional Notes
Additional Notes
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