BCA Membership Application
Thank you for your interest in becoming a member of Brockton Community Access! BCA memberships are free to Brockton residents interested in training for television production. A finished production airs on public access channel 9. Please complete the form below to begin your membership process. Proof of Brockton residency must be provided in order to be considered.
Email *
Date *
MM
/
DD
/
YYYY
Full Name *
Street Address, City/Town & Zip Code *
Phone number *
Organization name, address & contact information (if applicable)
Emergency contact name *
Emergency contact phone number *
How did you hear about BCA? *
In the past, have you ever been involved with BCA? If so, please describe your involvement. *
Next
Never submit passwords through Google Forms.
This form was created inside of Bcatv.org. Report Abuse