KOLN/KGIN'S Public Service Request Form

KOLN/KGIN's Criteria for Public Service Announcements

-Minimum of 6 weeks notice prior to event unless agreed to by management

-No sponsorship mentions/logos

-No guarantee of news coverage

-All public service announcements will run out of available inventory

-No performance affidavit will be available

-10/11 management reserves the right to decline a request without explanation

You may fill out our online form below and click the submit button, or, you may PRINT out a copy of the form and mail it to:

KOLN/KGIN-TV ATTN: Public Service PO Box 30350 Lincoln, NE 68503

If you would like to submit an event to our Community Calendar please click here.

1.Contact Information

Name*

Address*

Phone*

Email*

2.Organization Info

Organization Name*

Organization Web Site (if none, type n/a)*

3.What are you requesting?*

	Talent Appearance

	Promotional Spot

4.If it's a promotional spot, is the spot already produced?*

	Yes

	No

	n/a

5.What event or message is your organization trying to promote?*

6.Anticipated air dates?*

7.Please enter your date of birth.

Month*		Day*		Year*


	8.Terms and Conditions

	YES, I have read, understand, and agree to the Web site usage agreement and privacy policy.


	* represents required fields Children under the age of 13 may not submit this form.