Program Proposal
MVCC-Miami Valley Communications Council
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Program Proposal Form
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Today's Date:
Producer Name
Phone Number
MVCC Member City Resident?
YES
NO
Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Production Title
Production Description
Single or Series for Show?
SINGLE
SERIES
STUDIO
PODCAST
ON LOCATION
Studio Show?
YES
NO
Location of Taping, if not studio
School Production?
YES
NO
Name of School
Estimated Date of Completion
Print/Sign Name
EQUIPMENT RESERVATION
Date to be Checked Out?
Date to be Returned
CAMERA PACKS
Sony HXR-NX70U - numbers of needed cameras
1 - CAMERA
2 - CAMERAS
3 - CAMERAS
EMC-XM1 (shotgun) mic AC adapter and power cord Headphones USB Cable
Sony HXR-NX5U - numbers of needed cameras
1 - CAMERA
2 - CAMERAS
3 - CAMERAS
EMC-XM1 (shotgun) mic AC adapter and power cord Battery
ADDITIONAL EQUIPMENT
Add addtl Equipment needed along with quantitiy
ACCESSORIES
Tripod Manfrotto (# needed)
1
2
3
SD Card (#needed)
1
2
3
Wireless Mic (#needed)
1
2
3
Handheld Mic (#needed)
1
2
3
Shotgun Mic (#needed)
1
2
3
Mic Stand (#needed)
1
2
3
XLR / Audio Cable (#needed)
1
2
3
Miniburst LED Light (#needed)
1
2
3
Light Stand (#needed)
1
2
3
Traditional Rifa Light Kit (#needed)
1
2
3
Submit
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