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BICYCLED (NON-LOCAL) PROGRAM SPONSORSHIP FORM
Form RCTV-4
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Sponsor Name
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Sponsor Phone
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Sponsor Address
(Sponsor must be a
Raymond resident)
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Sponsor E-Mail
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Producer Name
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Producer Phone
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Producer Address
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Producer E-Mail
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Program Title
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Type
(Check all that apply)
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q Ongoing Series
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q Limited-Run Series
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q One-Time
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Requested Initial Cablecast Date
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Requested Initial
Cablecast Time
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Requested Replay Cablecast Date
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Requested Replay
Cablecast Time
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Videotape Format
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q VHS/SVHS
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q DVD
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q Mini DV
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Original Production or P.E.G.
Access Facility
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Facility City & State
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Facility Phone
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Program Description
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Sponsor Signature
___________________________________ Date___________
By signing above I understand and agree that as a
Raymond resident, I accept responsibility for the content of the program in
question, and allow my name and telephone number to be given as a reference
for those with questions or comments about said program. I certify that the
program complies with all of the rules stated in the Raymond Community
Television PEG Access Policies.
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