Please complete the form below to the best of your ability. The information provided will be reviewed by the Program Committee to evaluate your proposal, and see that it aligns with our mission and standards. You will be contacted by our Program Manager directly regarding this process. Thank you for your interest in participating in community media!Producer InformationYour Name First Last Proposed Program TitleProducer Name First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Host Host is same as producerHost Name* First Last Host Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Host Email* Host Phone*Host's Bio, Resume, or Other Relevant Experience Information*Organization DetailsIs this program representing or on behalf of a business/organization? Yes NoOrganization/Business Model* For Profit Not for Profit Organization/Business Name*Organization/Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Organization/Business Phone*Organization/Business Website* Organization's MissionWhat audience are you trying to reach?What are the goals of the program?Have you ever hosted, produced or been a guest on a TV or radio show? Yes NoList when, where, and the format you hostedWhich of the following program formats you think you would prefer? One Time Once a Quarter Bi-Monthly (every other month) Once a MonthPrograms are up to 28 minutes in length. Producing a monthly program on BCTV requires advance planning to ensure that you can fill your on-air time, and so that we may staff and promote your program accordingly. Sometimes program ideas lend themselves best to a quarterly program or only a one-time program. Please think about your idea carefully and select the program schedule format that you feel is the best match.List a minimum of six topics you intend to present*If you are interested in an ongoing monthly program, please list a minimum of six topics you intend to present or discuss. Proposals without at least six topics will not be considered.If you plan to have guests, please list a minimum of six potential guests or interviews for your programExplain how you plan to present information on your programTypically, producers use guests, video clips, still photographs and other visual aids in the studio. BCTV has limited resources to do off-site taping, and this may incur additional production costs.Provide at least three examples of how you will promote your program.BCTV depends on its producers to help publicize its programs.Would you be willing to collaborate with another organization similar to yours to get you started? Yes NoWe receive many program proposals. We ask this question due to our limited time periods for airing shows.Recognizing BCTV’s status as a non-profit corporation, there will be no obscene, indecent, libelous or slanderous material, no inflammatory material, no lottery is involved and no lottery information will be cablecast; there will be no religious proselytizing, no commercial advertising and no political campaigning.BCTV is a nonprofit organization that relies on donations and sponsors to provide community media services. Each program on BCTV must be underwritten at the minimum level of $1000 for 12 months. All producers are expected to obtain underwriting support. Producers will work with BCTV's Executive Director and Program Director to assign this support to the program, and to initiate an agreeable payment schedule. Rates are established by the Board of Directors and are subject to change. I have read all of the above and agree. I do not agree.Final AgreementName* First Last Date MM slash DD slash YYYY Verify and Submit
