Program Proposal Form

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CITIZENS   T ELEVISION,   I nc.   P ROGRAM   P ROPOSAL   F ORM  
 
(This   r elease   m ust   b e   s ubmitted   p rior   t o   p roduction   o f   s how)    
2666   S tate   S t.   S uite   # 4  
Hamden,   C T   0 6517  
Tel:   2 03.562.2288  
Fax:   2 03.562.0864  
 
 
Program   N ame:   _ _____________________________________________________________________________  
 
Running   T ime:___________   D VD   F ormat:_____________________   S ingle:______     S eries:_________  
 
Producer’s   N ame:____________________________________________________________________________  
 
Address:_______________________________________________________________________________________  
 
Phone   ( Day):_______________________   ( eve):________________________   O ther:___________________  
 
Requested   A ir   T ime   &   D ates:________________________________________________________________  
 
Assigned   A ir   T ime   &   D ates:____________________________________________   C hannel:___________  
 
Program  
Description:___________________________________________________________________________________  
_________________________________________________________________________________________________  
_________________________________________________________________________________________________  
_________________________________________________________________________________________________  
_________________________________________________________________________________________________  
 
 
Footage   A pproval   D ate:_________________________________(Aprox.   1   m onth   a fter   p roposal)  
 
Production   S chedule:   A   t ypical   ½   h our   p rogram   s hould   b e   c ompleted   1   ( one)   m onth  
from   t ime   o f   p roposal,   a   1   h our   s how   w ithin   6   w eeks.     A t   t he   t ime   t he   p roposal   i s  
submitted   a n   a ppointment   w ill   b e   s cheduled   w ith   t he   C TV   P rogram   D irector   t o  
discuss   t he   p rogress   o f   t he   s how   a nd   t o   r eview   t he   f ootage.     F ailure   t o   m eet   w ith  
these   r equirements   c ould   l imit   y our   p rivilege   t o   u se   t he   f acilities   a nd   e quipment   a t  
Citizens   T elevision.  
 
Producer’s   S ignature:______________________________________________________   D ate:___________  

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