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Network Affiliate Referral Program - Confirmation

The purpose of this confirmation submission process is to validate the intent of the referred station to grant the BarnabasRoad.com referral credit to the Network Affiliate making the referral. Our intent is to allow our new Network Affiliate the opportunity to thank the referring station or network for the advice in making connection with Barnabas Road Media.

Barnabas Road Media thanks both parties for their business and participation in this Network Affiliate Referral Program.

Station/Network Name:

Confirmation Code:

Your E-mail Address:

City and State:


Name of person making referral and comments: