09:36pm, 09/06/10
Untitled Document
WXFL WWW
Listener Club
96.1 WXFL has an all new KIX Club. Our goal is to personalize your information from our site and with our club. So, all we ask is to fill out the form below! And so you know, we will NEVER share your information or e-mail address with ANYONE! Thanks for signing up as a WXFL KIX Club member!
»  Username :
 		 
 
»  Email :
 		»  Confirm Email :
 
»  Password :
 		»  Confirm Password:
 
»  First Name
 »  Last Name
 
»  Address 1
  
 
»  City
 »  State
 
Zip / Postal Code
  
 
Country
 
Cell Email
  
 
Phone
 -   -  		 
 
Company Name
  
 
»  Gender
 »  Date of Birth (mm/dd/yyyy)
 /   / 
 
»  Would you like to receive emails from us?
  Yes   No
 
»  How often do you visit the site?
Once a year Once a month
Once a week Once a day
Several times a day

»  When do you listen to the radio during the week?
6am - 10am 10am - 4pm
4pm - 8pm 8pm - 12am
12am - 6am None

»  When do you listen to the radio during weekends?
6am - 10am 10am - 4pm
4pm - 8pm 8pm - 12am
12am - 6am None

»  When do you visit the website during the week?
6am - 10am 10am - 4pm
4pm - 8pm 8pm - 12am
12am - 6am None

»  When do you visit the website during weekends?
6am - 10am 10am - 4pm
4pm - 8pm 8pm - 12am
12am - 6am None

 Submit
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