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Request to Broadcast Form

2. Date*
   Date
4. Name
5. Organization (must be located within the City of The Colony)
7. Email Address
8. City
10. Fax Number
11. Phone Number
13. Instructions
    Please enter the desired text in the space below, or attach a separate document that contains the text of the announcement you wish to have broadcast on Channel 16 upon TCGTV approval. The City of The Colony reserves the right to deny this request, or to edit the text, if necessary. The information provided should be for announcement of a one-time event, not an on-going program. Information shall not exceed one screen and generally should only include the organization, activity or function, location, date and time. No videotaped or live broadcasts. Please submit form one week prior to airing. The information will be displayed a maximum of two weeks.
15. Desired text to display*
17. Upload document
18. Start Date
    Start Date
19. End Date
    End Date
21. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
23. Electronic Signature
25. Approved
26. Rejected
27. Initials
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field