KFOK Community Radio Broadcaster Application

About You Name: Address: Telephone number(s): Email address: Drivers license number: Emergency contact: Describe your broadcasting experience, if any, or any education, training, and work or life experience applicable to broadcasting: Date of birth:

List FCC or other broadcasting licenses you hold, if any: Are you willing to share broadcasting expertise, if any, with others? KFOK, a cooperative venture, requires all broadcasters to commit to a minimum number of service hours depending on the amount of time each broadcaster spends on the air each monthgenerally 936 hours of service per year. (New broadcasters are required to complete 4 hours of service before going on the air.) Describe your personal and professional skills as they may apply to administration, finance, fundraising, marketing, technology, and general organizational aptitude:

Tell us about how you found out about KFOK and what interests you about joining us and becoming a broadcaster:

Add anything else about yourself youd like to share:

About Your Program Proposed name: Preferred days and times: (Refer to the broadcast calendar posted at KFOK.org; any program listed without a persons name or the words prerecorded show is automated music and may be superseded by a live program.) Describe your programs format (music genres or talk-show topic):

Describe your intended audience:

Describe a typical show:

By submitting this form, I acknowledge that I understand that fulfilling my servicehour commitment is a condition of remaining a broadcaster in good standing. Email your completed application to programdirector@kfok.org, or mail it to Program Director KFOK Community Radio PO Box 4238 Georgetown, CA 95634 When your application is approved, we will contact you and provide you with instructions and documents to get you started. To begin with, you will be asked to participate in a two-hour hands-on KFOK broadcaster training session to be scheduled for a day and time convenient for both you and a trainer. At that time, we will request that you pay a $25 training fee. Thank you for your interest! 3/1/11