| First Name | Textfield | - |
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| Last Name | Textfield | - |
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| E-mail: | E-mail | %useremail |
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| Phone(s): | Textfield | - |
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| Address: | Textfield | - |
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| Possible Program Name | Textfield | - |
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| Please describe your potential broadcast/program. | Textarea | - |
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| Will this program be live or pre-recorded? | Textarea | - |
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| Will this program be produced at the WCRS studio, or at a different location? (note: studio is currently closed for the forseeable future due to COVID-19) | Textarea | - |
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| What is the length (half-hour, hour, 1 ½ hour, other) of your potential program? | Textfield | - |
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| How often (weekly, daily, other) would you like your potential program be produced? | Textfield | - |
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| How will your potential program support the below mission and vision of WCRS LP-FM? | Textarea | - |
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| Are you willing to involve other WCRS volunteers/trainees in your program as assistants, contributors, or apprentices? | Textarea | - |
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| What is your previous experience in radio broadcasting or other comparable activity such as television, audio-video production | Textarea | - |
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| What other programs on WCRS may be similar to your proposal? How would your program be unique, from programs aired on WCRS ? | Textarea | - |
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| What is your favorite syndicated and locally produces show on WCRS? Why? | Textarea | - |
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| Please review the WCRS mission and describe how your program will help to fulfill it. | Textarea | - |
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| Have you read and understood, and do you agree to abide by the WCRS rules and guidelines? | Textarea | - |
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| I have read and agree to comply with the “WCRS Broadcasting Guidelines." see Below | Select options | - |
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| Please list 2 or 3 References that reflect your community relationships, personal interests, or professional experiences. | Textarea | - |
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