Event Request Form

GNAT-TV EVENT COVERAGE REQUEST FORM

Please fill out the following information as completely as possible and submit at least two weeks prior to the event.
There are three ways that GNAT-TV can assist you in covering your event. (Please choose one of the following options.) *

1. You provide the volunteer, GNAT-TV provides equipment and training (Call 802-362-7070 or email production@gnat-tv.org to schedule training; fees may apply). 2. GNAT-TV staff producers/editors are available for a fee. The GNAT-TV production team will send you an estimate after completion of this event request form. 3. GNAT-TV may provide coverage based on certain criteria found here gnat-tv.org/event-request-form
Name of Event *
Event Date / Start Time *

Month Day Year Hour Minutes AM/PM Option
Event Date End Time (May Be Approximate) *

Month Day Year Hour Minutes AM/PM Option
Name of Speaker/s *
Event Location *
Please be specific and add directions if it is difficult to find.
Purpose of Event Coverage: *

For broadcast on GNAT-TV cable channels and website For organizational, private, or commercial use (e.g. website, sales or training, promotional) To capture the moment / record of the event for casual use
Requested Services: *

Filming Only Filming and Editing Filming, Editing, Distrubution
Do you intend to sell this video content? *

Yes No
Is the Event Free and Open to the Public? *

Yes No
Broadcast Requirements
GNAT-TV requires that the host / sponsor get permission from the speakers/presenters appearing on camera prior to the event. *

Yes, I have received permission.
A Cablecast Request Form must be completed by the host / sponsor acknowledging responsibility for the content of the program. (Applicable if the program is for cablecast and online distribution) *

I understand
Organization Contact Details:

Event and Organization Contact Information.
Organization Name *
Organization Address
Please Indicate Type of Organization: *
Event / Organization Contact Name *

First Name Last Name
E-mail *
Contact Phone *
Venue Details:
Venue Contact Name

First Name Last Name
Venue Contact Phone
Include ext.
Venue Contact E-mail:
Event Details:

Please take a moment to fill out the following info so that we may provide the proper production equipment and staff. Thank you.
FORMAT OF EVENT: *

One person speaks Multiple speakers, one at a time Panel Discussion Round Table Audience Participation
Will the Film Crew Have Access to Power? *

Yes No
Will the Film Crew Need to Provide Additional LIghting? *

Yes No Not Sure
Will you be using a sound system at the venue site? *

Yes No Not Sure
Will the presenter(s) be using Power Point presenations or other types of slides? *

Yes No
How many slides?
How many people do you expect to attend the event? *
Who is Your Target Audience?
If GNAT-TV provides production services, will GNAT be publicly recognized as a Media Partner in your promotional materials and/or at the event? *

Yes No
If GNAT-TV is unable to film your event, are you or someone from your organization interested in receiving videography training? *

Yes No
Should be Empty:

GNAT-TV EVENT COVERAGE REQUEST FORM

Broadcast Requirements

Organization Contact Details:

Venue Details:

Event Details: