Intoxicated Radio Application Form

Send To:

Please complete the following details:
* Name:
* Email:
* Desired DJ Name:

A * indicates that a field is required

Three Genres Of Music You Like / Wish To DJ With?:
Genre One:
Genre Two:
Genre Three:

Operating System / Internet Details:
Operating System:	Windows 95/98 Windows XP Home/Professional Service Pack 2 Windows Vista (ALL Versions) Macintosh (Any OS) Linux or UNIX Based.
Other? (Please Specify):

Is your IP Address, either:	Static IP Dynamic IP

Have you ever DJ'd before?:	Yes No

If yes, did it have a Music Request System?	Yes No N/A

Tell us about yourself:


Why do you want to DJ for Intoxicated Radio?



Please Note! You must be Eighteen Years of age or Older to DJ for Intoxicated Radio. Thankyou.

This is simply an application form, none of the details will be shared with anyone outside of the Intoxicated Radio Management or Technical Support. We will never ask you for confidential details such as Credit Card Numbers, Access to Email Accounts or other personal information. The questions contained within this application are to assist us, the radio station with processing everything as quickly as possible. We thank any applicant for the interest in Intoxicated Radio.