Community PSA Request Form

Burlington County College’s WBZC accepts public service announcements from local organizations in the South Jersey area. Any announcements involving politics or religion are strictly prohibited. All announcements are screened by WBZC management. Burlington County College and WBZC reserve the right to not air announcements.

All announcements must be received no later than 3 weeks prior to event or service.
Contact Information
Contact First Name*:
Contact Last Name*:
Contact Phone Number*:
Contact Email Address*
Organization Information:
Title in Organization*
Organization Name*
Organization Website
Organization Phone Number*
Event/Services Information:
Name of Event or Services*:
Date of Event*:
Time of Event*:
Location of Event*:
Brief Description of Event or Service*:
Target Audience* (check all that apply):
Under 18. 18-34 25-54. 55 Plus Male Female
Is this a family event?*
Yes No
Where do listeners go for more information?* (website, phone number, email address, etc.)

*Indicates a required field