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Program Series Submission

2. 

4. Attach proof of residency.

   Driver's license, state issued I.D., or utility bill with current address are accepted.

6. Series Title (max. 25 characters)

7. Date
   Date

9. Series Descriptions (max. 200 characters)

11. Number of Programs in Series

12. Frequency of Programs

14. Topic of Series

15. Program Length

17. BCTV Production

    1. Yes
    2. No

18. Other

22. Adult Content (check all that apply)

    1. Language/Profanity
    2. Nudity
    3. Sexual Content

    1. Depicts Violence
    2. Other

24. Is this program suitable for viewing by children?

    1. Yes
    2. No

28. Name of Program Creator

30. Program Creator Email Address

32. Program Creator Phone Number

36. Sponsor Information
    This section is to be completed if you are not the creator of the program, but are sponsoring the playback of the program on BCTV.

    This section is to be completed if you are not the creator of the program, but are sponsoring the playback of the program on BCTV.

38. Name of Sponsor

40. Street Address

42. City

43. State

44. Zip Code

46. Sponsor Email Address

48. Sponsor Phone Number

52. Click to read Operational Rules
    OPERATIONAL USE POLICIES

54. I certify that I have read Burnsville Community Television’s OPERATIONAL USE POLICIES, and I understand that I am responsible for the content of the program that I produced for playback on the access channel(s). I understand that if I am sponsoring a series of programs as a resident of Burnsville not made at Burnsville Community Television and/or not produced by me, that I assume the same responsibilities as a producer for the content of the program according to the OPERATIONAL USE POLICIES. I affirm that:
    • No lottery information will be cablecast • No obscene/indecent material or language shall be cablecast, nor programs that promote illegal acts. • The program contains no advertising, soliciting for funds, or revenue generating activity. • All clearances have been obtained from performers/talent, stations, sponsors, copyright holders, etc. • If a live cablecast, I have taken reasonable measures to ensure compliance with this statement.

    • No lottery information will be cablecast • No obscene/indecent material or language shall be cablecast, nor programs that promote illegal acts. • The program contains no advertising, soliciting for funds, or revenue generating activity. • All clearances have been obtained from performers/talent, stations, sponsors, copyright holders, etc. • If a live cablecast, I have taken reasonable measures to ensure compliance with this statement.

56. I assume full responsibility for any disputes arising from unauthorized use of copyrighted material. As producer or sponsor, I am solely responsible for the content of this program series.

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59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field