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`Olelo: The Corporation for Community Television

Playback Request

  • Program contains matter designed for Adults Only
  • __ Yes __ No
  • (This will not necessarily pre-empt program from airing.)
  • Check One Only:

    Series Type:

  • __ Weekly (Two new programs per month)
  • __ Monthly (One program per month)
  • Non-Series:

  • __ Special
  • __ Premiere or __ Repeat program
  • Month Program Should Premiere: ____________
  • Program Length: ________________
  • PROGRAM TITLE:

    ½ Hour program (10 Characters Maximum, including spaces)

    ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

    One Hour or more programs (20 Characters Maximum, including spaces)

    ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

  • Program Category: (Check Only One)
  • ___ Arts & Performance
  • ___ Educational Issues
  • ___ Native Hawai`i Issues
  • ___ City Government Issues
  • ___ Environmental/Health
  • ___ Issues
  • ___ Personal Growth
  • ___ Comm. Service/Infor
  • ___ Inspiration
  • ___ Social/Political Issues
  • ___ Cultural/Ethnic Issues
  • ___ National/Int'l Issues
  • ___ Sports
  • ___ Economic Issues
  • ___ Native Hawai`i
  • ___ State Government Issues
  • ___ Education/Instruction
  • Scheduling Information: (Check all that are appropriate)
  • __ Created on Oahu
  • __ `Olelo Grant Program
  • __ Created/Neighbor Island
  • __ Created/Out-of-State
  • Preferred time of cablecast: ___________
  • ___ 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:
    __________________________________________________________________________
    __________________________________________________________________________

  • Which Sector are you From: (Check One)
  • __ Public __ Educational __ Government
  • Program Summary: (60 characters or less, including spaces)
  • ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
    ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
    ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

    Presenter Signature:___________________________________

    Date:______________________________________________

    Mailing Address: __________________________________________________________________

    City:___________________________State:__________Zip:__________________

    Phone Number:

    Day:__________________Night:__________________Fax:__________________

  • For Office Use Only
  • Date Received: __________
  • Staff Initials: ____________
  • Return to
  • `Olelo: The Corporation for Community Television
  • 1122 Mapunapuna Street, Honolulu, HI 96819
  • Voice: (808) 834-0007
  • Fax: (808) 836-2546