Four programs with four cablecast forms and a signed access user contract must be submitted before a time slot is granted.

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Click Here to get a printibable form. Click on the icon to get the free reader.

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Program Title:
First Name:
Last Name:
Address:
City:	Bridgeport Fairfield Milford Orange Stratford Woodbridge
State:	CT
Zip Code:
Telephone Day:
Telephone Night:
E-Mail:
Program Length:	30 Minutes 60 Minutes
Type of Program:	P E G
How Many Weeks:
1st Choice of Day:
1st Choice of Time:
2nd Choice of Day:
2nd Choice of Time:
3rd Choice of Day:
3rd Choice of Time:
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Time Slot Form

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