Cablecast Request Form

Send your program to our department manager and we will work with you to get it into our show programs. Requirements: must be a resident, student, or employee of  Bridgeport, Fairfield, Stratford, Milford, Orange, or Woodbridge.

Your Information

Name:(Required)
MM slash DD slash YYYY
Address:(Required)

Program Information

Type of Program:(Required)
Exact Program Length:
Cablecast Information:
MM slash DD slash YYYY
If DVD Disk DVD_R Enter Cue Time:
Does The Program Contain Any Potentially Offensive Material?(Required)
Does The Program Contain Any Adult Content?(Required)
Does The Program Contain Copyrighted Material?(Required)
If Necessary, Has Appropriate Copyrighted Permission Been Obtained For Use In Program?(Required)
Consent Agreement:(Required)
MM slash DD slash YYYY