Request a Song Please enable JavaScript in your browser to complete this form.First Name *Last Name *Song Title *Artist *Additional Information Concerning the RequestEmail *Subscribe to receive emails from Rocking M Media *YesNoBirthday Club *Yes (If yes write your birthday below)NoWould you like to join the birthday club as we wish you a Happy Birthday on Social Media and On-AirBirthdayIf you would like for us to wish you a Happy Birthday on social media and on the airEmailSubmit