Program Information Sheet
Name
*
First Name
Last Name
Email
*
example@example.com
Program Working Title
*
Description of Program
*
Please Select
Talk Show / Interview
Music Videos
Variety / Performances
Church Services
Presentation
News
Narrative (Scripted)
Pick one that makes the most sense
Target Audience
*
Children
Adults 18-45
Adults 46-65
Seniors (over 65)
Men Only
Women Only
Religious
Non-religious
Other
Frequency
*
Please Select
Weekly
Bi-weekly (2x per month)
Monthly
Special (single show)
How often would your show air?
Length
*
Please Select
29 minute block
59 minute block
I plan to use Access 21's:
*
TV Studios (Must be certified in Basic Studio)
Editing facilities
Podcasting Studio (must be certified in Podcasting Studio)
None
Programming Quarter to start.
*
Please Select
Winter (Jan-Mar)
Spring (Apr-Jun)
Summer (Jul-Sep)
Fall (Oct-Dec)
*
Producer Signature
Submission Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Submit
Should be Empty: