| First Name* |
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| Last Name* |
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| Organization* |
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| Organization Title/Position* |
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| Organization Type* |
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| Street Address |
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| City* |
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| State* |
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| Zip* |
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| Phone Number* |
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| Email* |
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| Website URL* |
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| Organization Mission (Max 150 Characters)* |
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| Summarize your Organization in 6 Words* |
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| How will you let your current members know about your content on Gotta Love Fresno? (Check all that apply)* |
:Email
:Social Networks
:Organization Meetings or Events
:Newsletters
:Direct Communication (ex. phone, mail)
:Text Messages
:Blogs
:Website
:Other (Please Explain Below)
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| Describe any other methods of informing your members of content on Gotta Love Fresno (Must be no more than 150 characters) |
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| Number of online visitors (total in aggregate) for your organization's website per month* |
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| Number of Facebook friends or fans for your organization* |
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| Number of Twitter followers for your organization* |
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| Number of YouTube channel subscribers for your organization* |
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| Number of people in your organization's email or newsletter database* |
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| Will you upload a minimum of three videos to start?* |
: yes : no |
| Attach Your Channel Logo (.jpg - 99x99 pixels) |
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| For how long has video been a part of your organization's strategy?* |
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How did you learn about Gotta Love Fresno? (Must be no more than 150 characters)* |
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What is your goal in using Gotta Love Fresno? (Must be no more than 150 characters)* |
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| Do you have interest in... |
: Website Only : Website and VOD |
If you have interest in Website and VOD, what is your goal in using VOD? (Must be no more than 150 characters) |
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| Who Referred You To The Site? |
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| Security image |

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| Enter security image letters : |
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other: |