Cal Poly Pomona
RadioActive
Broadcast Application
Applicant Information
Full Name:
Date:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
Phone:
!
!
State
ZIP Code
Email
!
!
!
!
!
YES
NO
YES
NO
Are you a student at Cal Poly Pomona?
Have you applied for a previous show
through Cal Poly Radio Active?
Has the show that is being applied for
existed in any way prior to this application
process?
Do you plan on continuing this show past this YES
academic school year?
NO
If yes, when?
YES
NO
If yes, explain:
Sample Show
Please submit a 30 minute sample of what you would like to do for your show. It can be talk/comedy/music/news. We
are open to any type of creativity you want to bring to the table.
You can email a mp3 with this application OR upload through spreaker.com by making a personal profile for us to view.
Broadcast Day
(s) Requested:
Broadcast Time Slot
Requested
Optional day and
time requested
Short Description of
Show
[If Submitting 30 min Sample Show Through Spreaker.com]
Spreaker Account Name __________________________Spreaker Episode Show_______________! !
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application is accepted, I understand that
false or misleading information in my application or interview may result in forfeiture of show rights. By signing this, I also
agree to follow the guidelines and rules set under the Cal Poly Pomona Radio Active club charter, as well as those set up in
the Cal Poly Pomona Radio Active Manual.
Signature:
Date: