Program Rate Form Today's Date * Media Vendor * Market * Rep Name * Rep Phone * (Do not enter parenthesis, dashes or other non-numerical characters.) Rep Email * Name of Advertiser Name of Program * Is Program First-Run or Encore? * Choose OneFirst-RunEncore Day of the Week Start Date * Stop Date * Start Time * Stop Time * Internal Break * Choose OneYesNo Internal Break Rate (Do not enter commas or other non-numerical characters.) $ Adjacency Rate (Do not enter commas or other non-numerical characters.) $ Spot Length * Can spot run as a bookend? * Choose OneYesNo Demo Given by Buyer * Rating Projection * Rationale for Rating Projection * Impressions * (Do not enter commas or other non-numerical characters.) Does buyer need to know anything else? * Choose OneYesNo If you answered yes for buyer needing to know additional information, please add comments here: Note: If you have additional information or file attachments that you would like to share, please send a separate email and/or attachments to jhaggard@revenuedevelopers.com and reference this program submission form. Submit Please enable JavaScript for this form to work.