General Information:

Agency Name:

Client:

Product:

Commercial ID Number:

Commercial Title:

Client PO Number:

Client Job Number:

Estimate Number:

Class A Network Air Date Start:     Air Date End:

Class A 13 Week Network Guarantee

[If Class A - Fill Out Network Class A Uses Form Below]

Apply Session Fee

Apply Holding Fee

 

Program Air Date Start:     Air Date End:

13 Week Cycle

Class B Including New York  

Class B Without New York

 

Class C

 

Network Class A Uses Form

 

   Station                  Program                                      Date                         Length

             

             

             

             

             

             

             

             

             

             

             

             

             

For Additional Uses Fill in below

Notes:

Submitted and Authorized by:

Station            Program                                      Date                         Length

Station            Program                                      Date                         Length

Station            Program                                      Date                         Length

Station            Program                                      Date                         Length