welcome to the application form for the jammin jerry radio network
Before you fill out this application, please
click here to view the schedule, to see if the time you want is free.
the above link opens in a new window, so when your done viewing the schedule, simply close the window to return to this page.

Please fill out the following form to become a broadcaster on the jammin jerry radio network!

fields marked with a star (*) are required, and you must provide a valid phone number! The phone number will be validated if the number is not valid, your application will be rejected.

*Your first name:

*Your Last name:

*Your birth month:

*Your birth day:

*Your birth year:

*E-mail address:

*Confirm E-mail address:

Telephone number, to be used if e-mail fails to work:

DJ Name:

show title:

Show discription:

show start time:

how long will your show be?

show day:

what types of music will you play, separate multiple genre's with a comma.

will your show contain adult content?

other information that doesn't fit anywhere else:

after applying, if your application has been accepted, if you have any questions, you can contact our program director Return back to home page