MOXIE Record Service Sign Up Form ***PLEASE NOTE: We DON'T sell/give out your email, or use it to send you cyberjunk. We DO use it to keep you posted on music, opportunities with artists (interviews, concert reviews, shows @ your school), &, on occassion, to arrange advertising in your school paper. So, PLEASE give it if you have it, as it's an important way we keep you informed of stuff. School: Address City, State, Zip Closest City Type of organization: Newspaper Radio Station TV Station Student Council/SGA/ASB Name of your student organization (call letters, name of paper, etc) Faculty Advisor is Faculty Advisor email; include more than one if applicable: Student if any, we should be in contact with regarding music: Student grade: Student email: Is your paper online?** Yes No If yes, paper URL/web address: **If you would like to get your paper online, the American Society of Newspaper Editors has a free webhosting/software site for this at www.myhighschooljournalism.com. Questions/comments: We would like to extend our record service to other student organizations in your school if you think they would welcome it and/or could make use of it for their media & activities programs. To that end, please give us the relevant info under OTHER SCHOOL INFO below if you think they would also like to receive music, and we'll put them on our list. There is no need to fill out your own info again. If you don't think they would care to participate, go ahead & OTHER SCHOOL INFO Please note: only provide other people's emails if it is within your comfort zone to do so--we won't spam them, but understand why you may not be comfortable divulging that information. Does your school have a radio station/radio club? Yes No If yes, name of station: Faculty Advisor Radio Advisor email (if known) Does your school have a TV station/program/video club? Yes No If yes, name of station/program: Faculty Advisor: TV Advisor email (if known): Does your school have a newspaper? Yes No If yes, name of paper: Faculty Advisor: Newspaper Advisor email (if known): Who is the Student Council/Student Gov't/Student Activites/ASB advisor? Student Council Advisor email (if known) Questions/anything else we should know: You are now current and/or signed up for the 2008-2009 school year. Thank you for your interest & we look forward to working with you!