MENDHAM TV-25 INTEREST FORM

Name_________________________________ Phone_____________

Address_________________________________________

Student________ Resident__________ TV Experience______________

Interest (Check all that apply):

            - New/Event Brief _____(see below)

            - Original Program (see below)

            - Regular Programming (weekly/monthly)

            - Sponsorship_____ (contact me to support TV-25)

            - Help/Work at Station______ (contact me)

            - Governing Board_____ (contact me)

News Brief:

Event________________________________________________

Date_____________________________ Time __________________
(include day of week)

Site__________________________________

Sponsoring Group_________________ Phone # ______________

Other Info/Result (if complete) __________________________________________________________

Programming

Idea_____________________________________________

Length of Show/Event___________________________________

One-time_____ Regular Program (weekly/monthly)___________

Ready now?________ To be Filmed________ Edited________

Send to: Mendham TV-25, Township Hall, Brookside , NJ 07926 Or Call: 973-543-4555, ext. 110