Facility or Group Site Application
Click here to fill out a PDF form, or print this page. Then mail or fax either version of the application to the nearest Sun Sounds affiliate.
If you encounter difficulties with the application or have any questions, please call us at 480-774-8300 for more information.
SUN SOUNDS OF ARIZONA FACILITY APPLICATION (CONFIDENTIAL INFORMATION)
DATE _____________
FACILITY NAME _____________________________________________________________
CONTACT NAME/TITLE _______________________________________________________
ADDRESS _______________________________________________
CITY ______________________ZIP____________
PHONE ______-____________________
E-MAIL ____________________________________________
ADMINISTRATOR NAME/TITLE _______________________________________________________
MAXIMIUM NUMBER OF RESIDENTS ______________________________________
SELECT A DELIVERY METHOD: SCA RADIO FOR GROUP USE_______ TUNER________
Two copies of the Broadcast Schedule will be mailed to the contact at the facility each year. If you would like to receive the Program Guide in an alternate format please indicate the preferred format:
Braille_____Audio CD_____
AGREEMENT TERMS
Equipment loaned by Sun Sounds of Arizona or any of its volunteers or cooperating agencies remains the property of Sun Sounds.
Sun Sounds reserves the right to inventory the equipment at the facility with appropriate notice to the contact person listed or,
in their absence, the Administrator. The facility will pay current replacement value cost to Sun Sounds for any equipment that is lost, stolen, or otherwise unable to be produced for inventory within 30 days of the inventory request.
Signature _______________________________
Date _______________________________
FOR OFFICE USE ONLY
Delivered __________ Mailed __________ RECV”r# _____________ Freq_____________ DateRet'd____________
2ND#______________Freq_____________Rec'd_____________Ret'd_____________
MAIL OR FAX YOUR APPLICATION TO THE NEAREST OFFICE:
2323 W. 14th Street, Tempe, AZ 85281
480-774-8300
Fax: 480-774-8310
7290 E. Broadway, Ste. 166, Tucson, AZ 85710
520-296-2400
Fax: 520-298-6676
1300 S. Milton, Ste. 202, Flagstaff, AZ 86001
928-779-1775
Fax: 929-779-1775 press 9
1931 S. Arizona Ave., #4 Yuma, AZ 85364
928-329-6681 x20
Fax: 928-329-6715
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