Program Proposal


    Name and phone number of producer will be public information.

    Name *

    Address *

    City *

    State *

    Zip *

    Email *

    Phone1

    Phone2

    Tentative Show Title:

    Description: (Media Center will use this to publicize your show)

    If yes, how often?

    Projected Program Length:

    Production Facility and Equipment Needs

    Your Production Mode

    If yes, how often?

    How will you publicize the show?

    Other means

    Will the program contain harsh language or themes requiring parental discretion?

    (If so, Media Center will help you make a disclaimer and schedule playback in a later time slot.)

    I have completed the following classes at Media Center:

    All videos that you tape or edit using Media Center equipment must be made into non-commercial programs to be shown on our community access channels.

    Please check here:
    I am aware of the non-commercial and playback policy above.

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