WCTV Production Request Form

1.Basic Information
AE Phone #*
Client #*
2.Contact Information
First Name*
Last Name*
Phone Number*
3.Shoot Information
Projected Start Date of Spot(s)*
Number of Spots*
Length of Spots*
4.Who is Writing the Script? (Input a script or copy points)*
5.Charges Information*
WCTV Preferred Package ($350)
WCTV Basic Package ($250)
Agency Services ($150/hr)
WCTV Audio/Video Tag ($50 each)
No Charge
6.After Hours Shoot?*
7.Discount Info*
Multiple Cut (20% Off)
Annual Client (10% Off)
No Discount
8.Distribution (List Email Addresses of Who Needs to Receive the Spot or Spots)*
9.Additional Information*
* represents required fields
WCTV 1801 Halstead Blvd. Tallahassee, FL 32309
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