MOXIE STUDENT COUNCIL ASB SGA STUDENT ACTIVITIES SIGN UP • UPDATE 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), & to check in with you on how the music we sent is faring... 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


Faculty Advisor is:


Faculty Advisor email:


Student, if any, we should be in contact with regarding music:


Student grade:


Student email:


Any questions or comments?


OTHER SCHOOL STUDENT ORGANIZATIONS INFO

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 let us know the following if you think they would also like to receive music, and we'll put them on our list.

If you don't think they would care to participate, go ahead &

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 newspaper?
Yes
No

If yes, name of paper:


Newspaper
Faculty Advisor is:


Paper
Advisor email (if known)

Does your School have a TV station/TV program?
Yes
No

If yes, name of station or program:


TV
Faculty Advisor is:


TV
Advisor email (if known)


Does your school have a radio station/club?
Yes
No

Radio
Faculty Advisor is:

RADIO 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!