InterChange Radio
Please complete this form and submit it for consideration
 Company/Organization Name
 Street Address
 Zip Code
 Local Phone#
 Toll Free#
 Contact Person
  Title of Presentation
Length in minutes
Broadcast frequency of your presentation
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Prepare a press release about your presentation.  Please limit your release to 150 words:
 (you can prepare this statement in word or wordperfect and then paste it here)