PSA information for your event:
Contact FIRST name for event:
*
Contact LAST name for event:
*
E-mail:
Contact Phone:
*
Organization Name:
*
Federal Tax ID Number:
You must be a Federally recognized 501(c)3 tax exempt organization to receive free PSA's from KCMA. Please provide this number for our files.
START Date of Event:
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Month
-
Day
Year
at
/
Hour
Minutes
AM
PM
END Date of Event:
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Month
-
Day
Year
at
/
Hour
Minutes
AM
PM
Location of Event:
*
Brief Description of your event:
Would you like the Boom Box* at your event?:
Yes
No
*Please note that fees apply for Boom Box. We will contact you at the phone number provided.
Upload a picture file of your event flyer:
Enter the code shown to the right:
*
Submit
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