Kingston
Area Public Access Channel 23
Producer Application
Form
Date Applied: ____/____/_____ Date to Renew: ____/____/_____(1 year)
New
Applications:
Please complete the following form, make a copy of your driver’s license or
other form of picture ID and bring both with you to the next Producer
Application Workshop, which is held on the second Thursday of every month at
6:30 pm in Room 1 at Kingston City Hall.
Re-Applications: The completed form
can be USP mailed or emailed to the Commission or brought to the monthly
meeting.
Section
1: About you
Producer
Name:
________________________________________________
Telephone #: Day: ___________________ Evening: _________________
Mailing Address: ________________________________________________
________________________________________________
Email Address: ________________________________________________
ID or License #: ________________________________________________
(Please keep us informed if any of your contact information changes so that we can keep you updated about changes and events at the studio.)
Section 2: About your
Program:
Program Title: _____________________________________________________
1. Will your program have any of the following mature material:
Nudity ____Y ____N Obscenity ____Y ____N
Profane Language ____Y ____N Gore ____Y ____N
2. Are you at least 18 years of age? ____Y ____N
3. Are you willing to volunteer some time to help maintain the studio?
____Y ____N
4.
Are you available to volunteer on one of the Station Committees? List any areas
of expertise you may have. (technical, fundraising, production, etc.) ____Y
____N
Areas of Expertise: ____________________________________________________
5. Which of the following best describes your program: (check one)
___Public ___Educational ___Official Government
6. Will you require technical support to broadcast your program?
____Y ____N
(if yes, you will need each technical support person to fill out a tech support application)
7. Describe, in as much detail as possible, what your show is about, who your intended audience is, and how it will benefit the community.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
8.
Desired Time Slot:
1st choice Day _____________ Time _______________ ½ Hr ___ 1 Hr ___
2nd choice Day _____________ Time _______________ ½ Hr ___ 1 Hr ___
3rd
choice Day _____________ Time _______________ ½ Hr ___ 1 Hr ___
Bimonthly: 1st & 3rd wks ___ 2nd & 4th wks ___ OR Weekly ___Y ___N
9.
Underwriters: Please list
all underwriters you intend to have as sponsors for your program.
The Commission must be notified of changes in sponsorship in writing 10 days before any changes take place. (Please see Section III, 1.4 of the KAPAC Rules and Procedures for information on underwriters.)
1._______________________________________________________________________
2._______________________________________________________________________
3._______________________________________________________________________
Section
3: Producer Agreement Rules:
1. Upon leaving the facility all doors must be secured and locked.
2. All equipment must be turned off and secured with proper dust covers or other measures.
3. No unauthorized personnel may be allowed entry into the studio unless such personnel are direct participants in a program. The producer will take full responsibility for all invited personnel while in the studio facility.
4. The producer further agrees to provide a performance bond if so requested by the Commission.
5. Report all malfunctions in equipment to the Commission immediately.
6. Entrance to the studio is authorized by access code only. This code identifies the producer. Tech support personnel will not receive a separate access code. All arrangements to access the studio must be made with the producer. If the producer is suspended for any reason, tech support will not be allowed access to the studio facility. Unauthorized use will result in disciplinary actions as outlined in the KAPAC Policy and Procedure documents.
Along with this Producer Application you should have received the following Rules and Regulations documents: KAPAC Mission Statement, Policies and Procedures, Commission Bylaws, Calendar Bylaws, and Underwriting Credits Rules. It is your responsibility as a producer to familiarize yourself with all of the information contained in those documents.
I, _________________________________ have read the above listed rules and documents and agree to assume full responsibility as a producer and to uphold and keep current on all of the Kingston Area Public Access Cable Channel 23 Rules and Regulations, addendums and revisions or risk the penalties. I further agree not to share my access code with anyone.
_________________________________ _____/____/____
Producer Signature Date
Section
4: Commission Review
Commission Approval ____ Y ____N
The above applicant has/has not been approved as a producer. Approval has been denied for the following reason(s):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_________________________________ _________________
_________________________________ _________________
_________________________________ _________________
_________________________________ _________________
_________________________________ _________________
_________________________________ _________________
_________________________________ _________________
_________________________________ _________________ ____/____/____
Commission
Signatures Town/City Date
Training:
Type
of Training: Playback_____ Live_____ Other_______________________
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