`Olelo: The Corporation for Community Television
Playback Request
Check One Only:
Series Type:
Non-Series:
PROGRAM TITLE:
½ Hour program (10 Characters Maximum, including spaces)
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One Hour or more programs (20 Characters Maximum, including spaces)
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___ Time Sensitive (programs that address current events or subjects
that have a limited or
specific time frame, and which should be aired at a specific time
if it is to maintain relevance.)
Describe time sensitive nature and date restrictions:
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__________________________________________________________________________
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Presenter Signature:___________________________________
Date:______________________________________________
Mailing Address: __________________________________________________________________
City:___________________________State:__________Zip:__________________
Phone Number:
Day:__________________Night:__________________Fax:__________________