Viewing page 5 of 17

This transcription has been completed. Contact us with corrections.

Public Channel Application

TIME REQUESTED BY:
Name JAIME DAVIDOVICH

Address 152 WOOSTER NEW YORK 10012
Zip Code 10012

Telephone 212 254-4978
(area code) (home) (business)

Name and address of principle officer and title, applicable to organizations only.

Name _______________________

Address ____________________

Telephone __________________

PROGRAM TITLE AND BRIEF DESCRIPTION: EXPLAINS MY WORK AND "BASEBOARD" THE WASHINGTON PIECE

CHANNEL: C ____  D ______

Day(s) and Time(s) of the week requested:

Day: Mon __ Tues __ Wed __ Thurs __ Fri __ Sat ___ Sun __
Time: ____  ____  _____ ____ ____  ____ ___

Lenght of program in minutes: 22 Interconnect? [X] yes [ ] No

Period of Application: Start_____ End _____

Have you signed the contract? Yes _____ No _____

IF YOUR CONTRACT IS NOT SIGNED, YOUR PROGRAM WILL NOT BE PLAYED.

Applicant's Signature Jaime Davidovich
Date 1/5/76

(List on rear of page any persons under 21 years of age appearing in program)