GPAT 23 PROGRAM INFORMATION FORM / JOB ID#
1. Producer ID: / 2. Date Submitted:
3. Is this program a one-time submission or is it part of a series that is regularly sheduled:
------4. One time submission SKIP TO #10
------5. Part of a series
6. / Series Title
7. / Program Title:
8. / Date this program should run for the first time:
9. This program should run / ----- One Week / ----- Two Weeks
10. How are you submitting this program?
------11. DVD video 11A: Preroll Time: ______
Initial here to indicate you have read and understand GPAT rules about submitting DVD video: ______and SKIP TO #16
------12. Digital File on DVD media
------13. Digital File on portable media, such as flashdrive
------14. Digital file via cloud and internet. Name of cloud storage:
15. If digital file what is file name?
16. Do you want to pick up your media? / ------Yes / ------No
17. Program Length:
This should be an accurate duration of the program, not an estimate. / Hours / Minutes / Seconds
18. Religious content contains opinions, discussions, teachings or performances that relate to or manifest faithful devotion to an acknowledged ultimate reality or deity. Religious programs are cablecast on GPAT23 on Sundays and Wednesdays.
Does this program contain religious content? / ------Yes / ------No
19. Was program produced in PittCounty?------/ Y / N
20. Was program produced in Greenville? ------/ Y / N
21. Does program contain images of PittCounty or its Citizens? ------/ Y / N
22. Does program contain images of Greenville or its Citizens? ------/ Y / N
23. Does this program contain language or words or a word that are usually
not accepted as appropriate for general audiences of any age? ------/ Y / N
24.Does this program contain images that may violate community standards regarding obscenity? ------/ Y / N
25. Please describe contents of program, such as location, date recorded, names of people who appear in program. This may be used in promoting the program on the GPAT website, one Facebook or printed publications:
26. Statement of Compliance By signing below you agree that you have read and understand GPAT Rulesand certify that nothing in this program violates any of GPAT’s rules.
Local Producer Signature:
Date Signed:
27. This form is being submitted WITH MEDIA____ SEPERATE FROM MEDIA_____
If submitted separately, explain:
The GPAT Board of Directors reserves the final right not to cablecast a submitted program for whatever reason.
GPAT form #2.9 Revised 01/29/14

ALL DVDMEDIA MUST HAVE A LABEL stuck on the disc CONTAINING:

Local Producer's ID number (#000)

Title of program and additional information, if part of series.If series, premiere date.

Duration of Program

Pre-Roll Time (the amount of time it takes from the moment that the video tape or DVD begins playing to the moment the program begins.) Insufficient labeling will cause a delay in when the program will be cablecast.

GPAT File Name for GPAT office use: