Please fill in the information in all of the following fields and submit your application by selecting the submit button at the end of the application. A representative will contact you within 24 hours.


School Name
School Contact, Position
Address
City, State Zip Code
Phone best time to call
Grades in School
Current Student Population
Subjects in which programming would be used


Does the school own any TV sets? How many?
Does the school own a cable ready VCR? Any VCR?

(A VCR and TV will be needed to receive, view and tape our broadcasts)

My role is to    resources for teachers.

Who else at your school should receive information?

In feet and inches, how high, above ground level, is the roof of the school?
Please describe, as accurately as possible, your school's location, including cross streets, nearby major intersections, which side of the street the school is on (north, east, south, west), and how far into the block the school is located

(Needed for FCC purposes in the registration of receive sites)

Is your school accredited? Yes No

If so, please give dates of accreditation and the name of the accrediting entity or organization
Is the accrediting entity a state or regional body? State Regional