Remote Request Form REMOTE REQUEST FORM Please fill out all details: Salesperson (please select your name)*Peter BaumannClaudine DeChantJohn DelnegroMatt ArmstrongKim McCarthyChantel SquiresAudra ThielJim HeffernanSteve BenidtSteve CullyJoe MorrellStation(s)* Select All WAJZ WFLY WKLI WROW WYJB WINU Client* Contact Name & Phone #:* On-Site Contact Name & Phone #:* Remote Address:* Client Website:* Remote Date* MM slash DD slash YYYY Remote Time | From-To:* Remote Indoors or Outside: Indoors Outside Both Purpose of Remote (please be as specific if possible)*Requested Talent:* Talent Fee:* Remote Fee:* Number of Street Team Requested:* Phone Drops?:*YesNoNumber of Drops per Hour:* Setup: (Select All That Apply) Table Prize Box Enter to Win Box Photos Needed Setup Details:List any prizes or any text for setup Event Wrap Up: (Select All That Apply) Recap Photos for Client Other Wrap Up Details: Electric:* Electric Provided Live Broadcast Sound Mics Needed Type of music requested: Please include any additional information here
