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)

Will this program be a series?

If yes, how often?

Projected Program Length:

Production Facility and Equipment Needs

Your Production Mode

the studiofield equipment (camcorder, tripod, etc.)editing equipment

Will you be using your own camera?

If yes, how often?

How will you publicize the show?

NewslettersDistribute flyersSend postcardsPress release Ads

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:
OrientationCamcorderEditStudio

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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