request

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Fill in the information to let the DJ know you are tuned in and/or to make a comment or request a song.
Once you’ve filled in this form, your information will be saved for the next time.
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Name:
Gender:Male Female Not saying
Screen Name / Nickname:
Messenger Type:

E-mail Address:
Contact me:never once in a while a whole bunch
Location: (i.e., where you are geographically)
Internet ConnectionDial-up High-speed Don\’t know

Request: (fill in the genre only if you don’t care what song you want played)
Genre:
Artist:
Song:

Dedication/Comment:

related:
http://www.nhs.uk/Livewell/drugs/Pages/cannabis-facts.aspx
http://www.webmd.com/pain-management/features/is-marijuana-safe-web#1