Station call letters/Name of Stream:
Stream Format:
MP3 (recommended) Windows Media
Streaming bit rate:
20/24 kbps
32 kbps 56 kbps
64 kbps
Other kbps
Streaming Package: Monthly Maximum Concurrent streams (e.g., 50 pack):
Choose One 25 pack 50 pack 100 pack 200 pack 300 pack 400 pack 500 pack GT 500
Primary Streaming Contact:
Your Email:
Primary Phone:
Shipping Address (no PO Boxes):
Secondary Streaming Contact:
Secondary Email:
External Static IP address for encoder (e.g., 203.23.203.111):
Internal Static IP address for encoder (e.g., 203.23.203.111):
Gateway Address Information:
DNS Information:
Internet bandwidth access (e.g., T1, ISDN):
Will the encoder sit behind a firewall?:
yes no
URL of online pledge form if not using Quick Pledge™:
Pre-stream Audio Gateway Message?:
yes no
Notes (multiple streams, other questions or requests, etc.):