Underwriting Contract Agreement Date 05/27/2022Business Name(Required) Representative Name(Required) Email(Required) Phone(Required)Web Address Mailing Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contract Total(Required) Type(Required) Underwriting Spot Nonprofit EPSA Package(Required)One-TimeSix-Month ContractTwelve-Month ContractPayment Terms(Required) Monthly Full Amount Payment Method(Required) Cash Check Credit Card Credit card payments will be invoiced directly, according to Payment Card Industry (PCI) compliant standards.In exchange for your payment, your support of KPTZ will be acknowledged on air, and simultaneously via internet streaming, in specified announcement(s), voiced and produced by our staff. The underwriter may also provide a JPG logo file if desired for its display on KPTZ.org and other KPTZ materials.Number of Spots(Required)Start Date(Required) MM slash DD slash YYYY End Date(Required) MM slash DD slash YYYY Authorize Agreement(Required) I agree to the underwriting terms.By checking this box I understand that KPTZ will broadcast underwriting announcements in accordance with Federal Communications Commission regulations, acknowledging the underwriter's support of KPTZ. Announcements shall be consistent with all legal guidelines and with KPTZ station guidelines and policies. All terms and conditions of the "Media Kit" are applicable to this Contract, as Agreed by this authorized representative.Thank you for making a sound investment by becoming a KPTZ underwriter! KPTZ Radio 91.9 FM - PO Box 2091, Port Townsend, WA 98368 - (360) 379-6886 - underwriting@kptz.org Δ
