Station Agreement Form (English)

Station Information

Station Type*

Primary
Network Member
Translator of Station
Satelator of Station
Internet Station
Mobile APP

What network are you a member of?

Call Letters*

Frequency*

Band*

Power (in watts)*

Web Address

Would you like to link to our site?

Location of License*

City State / Province / Region Country

Contact Information

Contact Person*

Name Title

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

FAX

Airing Schedule

How often will you air UNSHACKLED! programs?*

Day(s)*

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Time(s)*

Be sure to indicate AM or PM and include time zone.

Language*

Other Information

Media Requested*

Satellite (E & S)
MP3 Download (E & S)
MP3 Podcast (E)

Would you like a program library?*

Only available for stations airing more than once weekly.

Yes
No

Would you also like to receive "Free Indeed!"?*

Yes
No

Is your air time paid by a local sponsor?*

Yes
No

Sponsor's Name

First Last

Sponsor's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Associated Outlets

Please list all PRIMARY STATIONS that you are associated with.

Type	Call Letters	Frequency	City, State	Day(s) & Time(s)

Guidelines For Broadcast Of UNSHACKLED!

To The Broadcaster: If you are in agreement with these guidelines and desire to broadcast UNSHACKLED!, complete the “Station Information Report” on the opposite side of this sheet, sign this agreement, keep a photo copy for your records, and return the original to: UNSHACKLED!, Pacific Garden Mission, 1458 S. Canal Street, Chicago, IL 60607.

Airing Schedules/Written Promos

An airing schedule is available online. It is important that you follow this schedule!

Promotional Announcements

Produced generic promos are included on each program tape or CD. These are for use during the week prior to the scheduled airing date. They are 25 seconds in length, allowing time for your station tag.

Custom Station Promotional Announcements

As a service to our broadcast partners, we provide, upon request, recorded custom promo announcements for Sharathons and other special events. Please make your request in writing, providing complete information, at least 60 days prior to the date needed.

Replication

Replication of UNSHACKLED! programs must be limited to one copy of each program per station library. All station libraries must only be accessible to the station(s) pre-approved to broadcast the program. If you desire to release the program to another affiliate, please contact us.

Cost

The cost of producing and distributing UNSHACKLED! is provided by the gifts of God’s people to Pacific Garden Mission, a homeless shelter founded in 1877. Because of our limited resources as a homeless shelter, Pacific Garden Mission does not purchase airtime on domestic radio stations, even though a radio program is one of the most costly types of programs to produce.

Copyright

Each UNSHACKLED! program is copyrighted. An approved station may not duplicate the program for any other station or affiliate without written permission of the president of Pacific Garden Mission. Stations airing UNSHACKLED! without permission are violating copyright laws. No portion of an UNSHACKLED! program may be used for any purpose other than as originally intended in its original completed form. UNSHACKLED! in any media format may not be sold, offered as “prizes,” or, in any other way, be assigned a monetary value.

Editing

Because UNSHACKLED! is the copyrighted property of Pacific Garden Mission, it may NOT be edited or altered in any way without written permission of the PGM president. This includes all story content, music, sound effects, and informational announcements. The only exception is the final 60-second music tag, which may be covered for sponsorship or station promotional purposes.

Sponsorship

Airing stations may find a sponsor for UNSHACKLED! A total of 60 seconds is available for the sponsor’s message at the end of each program. The program is timed to 30:00, including a 60-second music tag, which may be covered with the sponsor’s message. PGM will have no involvement in finding or endorsing a sponsor.

On-Air Interviews

The President of Pacific Garden Mission, as well as the UNSHACKLED! / FREE INDEED Program Manager are available for pre-arranged telephone interviews.

Program Distribution

Media in any format may be retained to build a station library. The exception is any cassette/CD marked “DATED,” which should be destroyed after the airing date. An undated cassette/CD is provided to replace each dated one.

Station Libraries

If a station is broadcasting UNSHACKLED! more than once a week, we ask that you establish a cassette or CD library of UNSHACKLED! programs by retaining the programs after the airing date. These programs may then be rebroadcast at a later date according to your own schedule. For stations without an established library wishing to broadcast UNSHACKLED! more often than weekly, PGM will provide a cassette tape or CD library upon request, without charge.

Communication

In order to effectively serve our (and your) listeners, we ask that stations respond to our requests for information in a prompt and complete manner, and also notify us if there is any change in your broadcasting schedule regarding UNSHACKLED!.

AGREEMENT

I agree to abide by the above guidelines for use of the UNSHACKLED! radio program, as specified by Pacific Garden Mission.

Do you agree to our guidelines (listed above)?*

I agree

Your Name*

Phone

This field is for validation purposes and should be left unchanged.