BCTV Membership Form
Use this form to join as an Individual or Organizational Member.
Name *
Your answer
Title
If you are representing an organization
Your answer
Organization Name
If you are representing an organization
Your answer
Street *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Email address *
Your answer
Phone Number *
Format: 000-000-0000
Your answer
Is your Organization a 501(c)(3)
If you are representing an organization
What is the mission of your Organization (briefly)?
If you are representing an organization
Your answer
Would you like to receive the BCTV Program Schedule via email?
Are you interested in crewing for productions?
Your Video Production Interests/Skills:
Your answer
How many of your staff might utilize these benefits?
If you are representing an organization
Your answer
Are there other ways you'd like to use BCTV to reach your community?
If you are representing an organization
Your answer
I have read BCTV Policies and Procedures and agree to abide by them: *
Are you over 18? *
If under 18, parental consent will be required.
Submit
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This form was created inside of Brattleboro Community Television.