CAM Program Submission Form

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This form needs to be filled out for every program that will be aired on Channel 29 or on the Corvallis Access Media Youtube page. Multiple shows contained within the same program (in a single playable file) only need one form filled out.

Date *

YYYY

First Name *

Last Name *

Are you under 18 years of age? *

Yes

Program Title *

Program title and video file must match and be named exactly as it should appear on the channel schedule

Program Description *

I am submitting this program as a: *

Local Producer

Non-Resident

Local Sponsor

Length of show: *

Hrs

Min

Sec

My program contains intense violence, intense sexual situations, strong coarse language, or intensely suggestive dialogue (TV14). *

If yes, you must include a 15 second viewer advisory at the beginning of the program. Please read the Warranty Agreement at the end of the contract for more information.

Yes

My program includes extreme violence or degradation, explicit sexual activity, or crude & indecent language (TVMA). *

If yes, you must include a 15 second viewer advisory at the beginning of the program. Please read the Warranty Agreement at the end of the contract for more information.

Yes

Equipment Use *

PEG Credit: "This program was produced by a member of our community using PEG access equipment managed by CAM."

I used CAM-managed equipment to produce this program, and have included the required PEG credit in my program. (Programs under 20 minutes excluded)

I used my own equipment for produce this program.

Required

Airing Instructions

Is this a time-sensitive program that should expire after a specific date? If so, please list below (otherwise, leave blank).

YYYY

Special Instructions for the CAM Coordinator

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