EBCTV Studio Request Form

Producer:
Day Phone:		Night Phone:		e-mail:
Name of Show

First Choice Date:		at
Second Choice Date:		at
Third Choice Date:		at

Live Show?	YesNo		Call-Ins?	YesNo
Live to Tape?	YesNo	Studio Segments Taped for Later Edit?		YesNo
Show Length?

Show Host			Host's Phone Number:
Show Guest #1:			Guest #1 Phone Number:
Show Guest #2:			Guest #2 Phone Number:
Show Guest #3:			Guest #3 Phone Number:
Show Guest #4:			Guest #4 Phone Number:

Number of Lavaliere Microphones Needed?			Number of Handheld Microphones Needed?
Wireless Microphone Needed?		YesNo	Cyc Curtain:	BlackBlueNone

Video Roll-Ins?		YesNo	Special Lighting Needs?		YesNo
If yes, Describe:			If yes, Describe:

On Set Furniture:	Other:

CREW INFORMATION
Name: Job: Phone Number:
Name: Job: Phone Number:
Name: Job: Phone Number:
Name: Job: Phone Number:
Name: Job: Phone Number:
Name: Job: Phone Number:
Name: Job: Phone Number:
Name: Job: Phone Number:

Additional Producer Notes Regarding this Request:

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This Page was last modified 3/30/05