Registration

Note: You must be 13 or older to register. Thank you!

1 What is your first name?

2 What is your last name?

3 What is your email address?

4 What is your gender?

Male
Female

5 What is your birthdate?

Month Day Year

6 What is your zipcode?

7 Which of these radio stations have you listened to at least once in the past week? (please select all that apply)

WJVL
Q-98 in Rockford
Q-106 in Madison
The Bull in Rockford
WSLD in Whitewater
WSJY - Light 107-3
105.9 Everything That Rocks in Janesville
Z-104 in Madison
WJJO in Madison
Other (please specify)

8 Which ONE of these radio stations have you listened to MOST in the past week?

WJVL
Q-98 in Rockford
Q-106 in Madison
The Bull in Rockford
WSLD in Whitewater
WSJY - Light 107-3
105.9 Everything That Rocks in Janesville
Z-104 in Madison
WJJO in Madison
Other (please specify)

9 How much time do you spend listening to the radio in a typical day?

Less than an hour
1 to 3 hours
More than 3 hours

10 We just want to verify that you know you're signing up to receive e-mail messages from us. Note: All submitted information will remain confidential and will not be used for any other purpose.

Yes
No