Phippsburg Community Access Television
Bulletin Board Application and Information
Phone:  389-2653 1042 Main Road, Phippsburg, ME 04562  Fax:  389-1522

Please us this form to submit information for display on Phippsburg Community Access Channel 7.   

Contact Person
Requested Start Date
Requested End Date 2 Weeks Maximum

1.  All Postings must include "For More Information" (FMI), Telephone Number & Name
2.  Information for display must be received 2 weeks prior to event

Please Type in Information that you would like to display below.

By submitting this request you agree to the following

I hereby represent that I am an authorized person from the above named organization and have the
capability of authorizing this information to be displayed on the Phippsburg Community Television Channel.

Furthermore, I hold the staff and volunteers harmless for failure to display, errors in display, other acts, or
omissions that prevent this information from being displayed on the requested days and dates.

All Town Business will be submitted and approved by the Town Administrator ONLY.

I understand nothing will be displayed which contains for-profit information.

Phippsburg PACTV Committee
Revised: 09/14/05