(All fields are required.)

Agency

Requested By

Telephone

Email

Date Requested
Date must be entered as MM/DD/YY.

Due Date
Date must be entered as MM/DD/YY.

Advertiser

Spot ID (Title, Length, ISCI)

Wild Spot Use

Date must be entered as MM/DD/YY.
Start     End

Majors: NY    LA    Chi
#Units (see below)

Cable Use

Date must be entered as MM/DD/YY.
Start    End

Program Use (aka Network Use)

Date must be entered as MM/DD/YY.
Start     End

Internet Use

1 Year    Maximum Period of Use

Theatrical or Industrial Use

30 days or less     Over 30 days

International Use

Talent Info

Wild Spot Weighted Markets

Comments/Other info