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Please print this form on your printer.
The form may be submitted by:
1. Faxing the form to Telecommunications Committee at 413-665-1446
2. Drop the form into the Telecommunications mailbox at the Town
Office.
SUNDERLAND
TELECOMMUNICATIONS
COMMUNITY CALENDAR
REQUEST FORM
Date Rec'd _____________________
**Please print or
type all information OR staple original clear copy to this form**
Today's Date: ______________ Request Air
Date: _____________ Delete Date: _________________
Requesting Organization:______________________________________________________________
Contact Person & Phone #
:____________________________________________________________
(name)
(Phone)
Message: (60 words or less - please note: all messages must be
individually hand entered into the system, so please be brief and
concise in your wording. Thank you for your cooperation.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
WE RESERVE THE RIGHT TO EDIT OR LIMIT ANY REQUEST AS NECESSARY
Upon completion, please put this form in the Telecommunications
Mail Box in the Town Office Building located at 12 School Street.
If this is an emergency announcement, please contact Tom
Zimnowski directly at work at 545-5767 or at home at 665-4724.
Calendar updates for Channel 15 are done on a weekly basis, usually
weekend to weekend.
**MESSAGES WILL NOT BE
POSED WITHOUT COMPLETION OF THIS FORM**
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