FORM MIGRATION TEST PAGE

Moody Radio Affiliate Info. Update

Name of Organization: *

Parent Organization(s) / Owner:

General Office Phone Number:

Studio Phone Number:

Station General Email:

Fax:

Address Street City State Postal Code Country

First Name:

Last Name:

Email:

I am interested in: Moody Radio News and Updates Special Opportunities Moody Radio Alerts ONLY

I have read and agree to Moody’s Terms of Use and Privacy Policy.

I agree

By submitting this form, you consent to receive promotional and other communications from Moody Radio, a ministry of Moody Bible Institute.