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GNAT-TV's Potluck Kitchen Sign Up Form
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Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Mailing Address
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Your answer
Email Address
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Your answer
Phone Number
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Town of Residence or Employment
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The Kitchen Project is open to anyone living or working in the GNAT-TV service territory. (Arlington, Dorset, Londonderry, Manchester, Peru, Rupert, Sandgate, Stratton, Sunderland, Weston, Winhall).
Arlington
Dorset
Londonderry
Manchester
Peru
Rupert
Sandgate
Stratton
Sunderland
Weston
Winhall
Other:
Recipe Concept
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What recipes or cooking tips would you like to demonstrate for the show? Please include any and all ideas that you would like to share on the show!
Your answer
Do you plan on having others with you on camera as co-hosts?
If yes, how many and list names if possible.
Your answer
Do you have friends or family that would like to participate as part of the production crew? (This is not required as GNAT-TV staff is available to Produce).
If yes, how many and list names if possible.
Your answer
What time of day are you available on Thursdays? (Please let us know if you are not available on Thursdays, you may make an appointment for another day below).
Morning
Afternoon
Evening
Other:
Please let us know other days and times that work for you.
Your answer
Thank you to the generosity of our local underwriters, GNAT-TV has scholarship opportunities available for those that may need financial assistance. Do you need assistance paying for ingredients and/or supplies?
*
Yes
No
Other:
Do you have any other information or notes you would like to share?
Your answer
Do you agree to share your recipe with GNAT-TV to be included in a GNAT-TV cookbook?
*
YES
NO
Required
GNAT-TV relies on donations from local businesses and individuals in order to provide community media services. Are you comfortable telling our audience how they can support us? (For example, "I am having a blast hosting this cooking show, please consider supporting GNAT-TV so we can keep it going").
*
I understand
Required
Please note that by participating, you agree to allow GNAT-TV to air and promote the program on our distribution networks. You will also be required to fill out our cablecast permission form (which can be found here:
https://gnat-tv.org/forms/cablecast-form/
).
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Send me a copy of my responses.
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