Welcome to the Easy Fan Club

Please complete the following information. You'll be entered into the Easy Fan Club. You'll also be entered into our weekly Birthday Drawing, and you might receive other prizes just for being a loyal listener of Easy Radio. We'll be sending out regular e-mail updates so be sure to include your current e-mail address. You may re-submit this form anytime your information changes.

Your Name

Your Address

City/State/Zip

Phone Number

Date of Birth

E-Mail Address

Our Anniversary Date