· To receive free material or to request more information about starting an

             international broadcast ministry, please complete the following form:

First Name
Last Name
Organization
Program Name
Street Address
City
State/Province
Zip/Postal Code
Country
Phone #1
Phone #2
Best Day / Time To Reach You
E-mail
Website

          · I currently have a Radio Ministry?

          Yes

          No

          · I currently have a Television Ministry?

          Yes

          No

          · I would like to receive the following free brochures by mail:

          Your International Outreach - Easy...Rewarding...Affordable
          Power and Potential of Shortwave Radio
         

          · I currently broadcast on:

          Domestic stations
          International stations
          Both domestic and international
          Neither domestic or international

          · I am excited to learn more about Outreach opportunities in the following regions

            of the world:

          North America
          South America
          Caribbean
          Europe
          Africa
          Asia
          Australia

          · Comments or Questions:

                    Promotion Code   ex. 756804