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Radio Station Application
This form is only for those persons employed by a broadcast radio station in the U.S. or Canada. If you work for a radio station, but not in the U.S or Canada click here.
First name *
Last name *
Call letters *
Moniker/Slogan
Dial position *
Station format *
Job position *
Station address *
City *
State/Province *
Postal code *
Country *
Include area code - if outside the U.S. the country code
Station phone *
Fax phone
RADIO ONLINE will send a test message to confirm the validity your e-mail address. The application will be placed on hold if the e-mail is returned undeliverable
E-mail address *
Your User Name (25 characters or less) is the unique ID that is used to login to your RADIO ONLINE account.
User name *
Provide a password that is one word - 12 characters or less
Password *
In case we need to verify your identity
Password Security Question *
Enter Your Response *
Primary interest *
* = required information

Notice: The information you provide is used for internal purposes exclusively; we do not sell or redistribute registration information. Incomplete registration forms will not be processed or acknowledged.

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