CHARLOTTE MECKLENBURG PUBLIC ACCESS CORP. PROGRAM INFORMATION SHEET Please print all information: Producer’s Name: _________________________________________________________ Address: ________________________________________________________________ Street Address - City - Zip Day Phone: _________________________ Evening Phone: _______________________ Organization Represented (If any): _____________________________________________ Program Title: ___________________________________________________________ Description of Program: ____________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Purpose of Program: ______________________________________________________ Target Audience: _________________________________________________________ Category (Check One): Type (Check One): _____ Religious _____ Foreign Language _____ Weekly _____ Informational _____ Sports _____ Bi-Weekly _____ Public Affairs _____ Children’s _____ Monthly _____ Arts & Entertainment _____ Single/Special (Check all that apply) I will use CMPAC: Length: 30 min _____ Studio _____ Length: 60 min _____ Editing _____ ____________________________________ ________________________ Signature of Producer - Date Signed FOR OFFICE USE ONLY Date Received: _______________ Date of Follow-up: __________________ Notes: ________________________________________________________________ Operations Manager Approval: _____________________________________________ |