Book A Remote Event & Remote Booking Internal Form used by sales and promotions department to officially submit remotes and other events. Client Name Contact Name at Account* First Last Contact Phone*WideOrbit Contract #* Address of Remote Location* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Site Location Details*INCLUDE THE NAME OF THE BUSINESS/LOCATION HERE, ESPECIALLY IF IT DIFFERS FROM THE CLIENT NAME! Otherwise, provide the promotions and engineering team with details of the remote site's physical location. (i.e. Setup inside the Kokomo Event & Conference Center, or Broadcasting live from outside Tipton High School.) The more information provided here, the more we can prepare to better serve your client.Event Date* MM slash DD slash YYYY Event Start Time* : Hours Minutes AM PM AM/PM Event End Time* : Hours Minutes AM PM AM/PM Talent*Tammy LivelyJR DennisNick LivingstonKenny BeasleySarah PageChris AlanSelect anyone that will be earning a talent fee for this remote or event, including on-air, promotions, and engineering talent fees.Promotional Asset Request WWKI Chevy WWKI 10'x10' Canopy WWKI 8' Teardrop Banners (2) WWKI Vinyl Banners WWKI Corn Hole Game WWKI Swag (Bags, Koozies, etc.) WWKI Provided Prize or Giveaway (Tickets, Passes) Client Provided Prize or Giveaway (Product, Service) Select all that apply.Is a regular phone line available for use during the broadcast? (May be a fax line. Cannot be IP-based or part of a phone system.)* Yes No If a phone line is available, what is the phone number of that line?Additional InstructionsAccount Executive or Organizer (Submitter)*Jacob WallJonathan RogersJohn SpilmanLise HayesMary Ann KilclineNick LivingstonSkylar AnthonyShelly BraggTammy Lively
