* Name

Address

City

State

* Zip Code

Phone

* Email

* Subject

Interests Programming
Engineering and technical
News and information
Marketing and Promotion
Fundraising
Funny Business

What would you like to hear on your community radio station?

What are the most urgent local issues for you?

What radio stations do you listen to?

Which station or program is your favorite? Why?

Would you consider being on the WROX Community Advisory Board? Yes
No

Might you have interest in volunteer work at the radio station? Yes
No

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* Other comments?