Q104 wants to play whatever you want to hear when you listen at work.
If you can't listen to your iPod at work...listen to Q104...because we want to play songs on YOUR Pod.
Send us 15 songs from YOUR iPod and we'll send you a $5 gift certificate from Mr. Chicken!

(You must be 18 to enter!)
It's Your Music Your Station... songs from YOUR Pod at Q104.
(One entry per person per 6 months. One entry per household.
You must complete the entire form with 15 DIFFERENT songs.)

What is on your Pod?
 
     
*1. First Name:
 
 
*2. Last Name:
 
 
*3. Email Address:
 
 
*4. Birthdate:
 
 
*5. Street Address:
 
 
*6. City:
 
 
*7. State:
 
 
*8. Zip:
 
 
*9. Daytime Phone:
 
 
*10. Artist:
 
 
*11. Song Title:
 
 
*12. Artist 2:
 
 
*13. Song Title 2:
 
 
*14. Artist 3:
 
 
*15. Song Title 3:
 
 
*16. Artist 4:
 
 
*17. Song Title 4:
 
 
*18. Artist 5:
 
 
*19. Song Title 5:
 
 
*20. Artist 6:
 
 
*21. Song Title 6:
 
 
*22. Artist 7:
 
 
*23. Song Title 7:
 
 
*24. Artist 8:
 
 
*25. Song Title 8:
 
 
*26. Artist 9:
 
 
*27. Song Title 9:
 
 
*28. Artist 10:
 
 
*29. Song Title 10:
 
 
*30. Artist 11:
 
 
*31. Song Title 11:
 
 
*32. Artist 12:
 
 
*33. Song Title 12:
 
 
*34. Artist 13:
 
 
*35. Song Title 13:
 
 
*36. Artist 14:
 
 
*37. Song Title 14:
 
 
*38. Artist 15:
 
 
*39. Song Title 15:
 
 
 
  Questions marked with * are required

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