94.1 JJO Advisory Panel Registration



Note: Federal law prevents your registration if you are under 13 years of age. Thank you!

Simply fill in the blanks (all blanks are required) and you'll be registered to give us your opinions. It's that easy!




1

Please Select a Username (user name can only be one word)
Try to use something a little unique like your first and last name combined, your hobby, birthday, etc.


2

Please select a password


3

Your first name


4

Your last name


5

Enter your email address


6

Gender

Male
Female

7

Your birthdate

Day Month Year

8

Your zip/postal code


9

Which of these stations have you listened to at least once in past week (multiple choices okay):

94.1 JJO
WMAD (Mix 92.1)
WIBA FM
WZEE (Z-104)
WMMM (TRIPLE M)
WXRX (THE X)

10

Which station did you listen to the most in the past week (choose only one):

94.1 JJO
WMAD (Mix 92.1)
WIBA FM
WZEE (Z-104)
WMMM (TRIPLE M)
WXRX (THE X)

11

How much time do you spend listening to the radio in typical day?

None
1 hour or less
More than 1 hour

12

We just want to verify that you know you're signing up to occasionally receive e-mail message from us. Note: All submitted information will remain confidential and will not be used for any other purpose.

Yes
No