WGLT TV 7 ~ GREENE LOCAL ACCESS TV CHANNEL
Phone: 946-5146 220 Main Street P O Box 510 Greene, Maine 04236-0510
Fax: 207-946-2102
Bulletin Board
Application and Information
Organization Name
__________________________________________________
Contact Person
______________________________________________________
Address
___________________________________________________________
Telephone _______________________ Email Address
______________________
Requested Run Dates: Start: Date _____________ Until: Date ______________
Information for Display: (Must include “For More Information” [fmi] Telephone Number)
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I hereby represent that I am an authorized person from the above organization and have the capability of authorizing this information to be displayed on the Greene Local Access Television Channel (WGLT TV7). Furthermore, I hold the volunteers harmless for failure of display, errors in display, other acts, or omissions that prevent this information from being displayed on the requested days and dates.
I understand nothing will be displayed which contains for profit information.
Signature __________________________________ Date _____/_____/_____
Date Received
____/_____/_____ Received by ____
Authorization Dates
Content
Date Put on Channel
_____/_____/_____
Posted By ___________
Date Removed from Channel _____/_____/_____ Removed by __________