First Name Last Name Title
MSO System
Street Address (No P.O. Boxes) Floor / Suite No.
City State Zip
Phone Ext. Fax
E-mail
DMA # of Subs Spot Rate
Name of Disney & ESPN Media Networks Representative
 
 
Activation materials will not ship until you have secured a local sponsor.
Materials will begin shipping to participating affiliates the week of November 10th.
Please contact your Disney & ESPN Media Networks Representative before proceeding if you have any questions.
 
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