Buyer/Licensee Profile
NETA 2008-2009 Collaborative Buy
  Buyer Agency
   		* required
  
 Buyer
Representative
 First name:* required
Last name:* required
 
Mailing Address * required
City * required
State Zip * required
Shipping Address
City
State Zip
Office Phone * required
 Office Fax
 Office Email * required
        
Broadcast or Transmission ID i.e., call letters
Agency type
Fiscal Year begins
Fiscal Year ends
FEIN #
 
  
   
           Program Distribution to Schools
         (Indicate P for Primary, S for Secondary)
  Broadcast
  Small-format tapes
  ITFS
  Cable channel(s)
  Satellite
  VOD
  Packaged Service
  Datacasting
  Other

Describe:

    

  
Types of Broadcast
Check all that apply
Open Air   
Digital   
Datacast   
Closed Circuit   
Video on Demand   
Packaged Service   

     

Service Area Population 
K-12 for 2006 - 2007 

You must fax documentation of  your K-12 population to NETA.  Acceptable forms include  photocopies of figures published  by state agencies, membership  lists, or contracts with population  figures for membership agencies.

NETA Fax: 803-771-4831
 
      		 * required
    This figure includes:
   (check all that pertain)
Public Schools Private Schools
Home Schools Parochial Schools
Vocational Ctrs Special Ed Ctrs
Homebound Pre-School
Correctional Institutions
Other (Describe: )
   

  


Program Delivery Format Preferences

   
Rank 1st, 2nd, 3rd, in order of preference
  1/2" Beta   DigiBeta
  DVC-Pro   DVC-Cam
  1/2" S-VHS  

  

  Targeted Tape Delivery Date:

  Person submitting this information  * required
  Date


This information is due at NETA on or before Friday, February 22, 2008.
Questions:  Contact John Chambers at NETA
Phone:  803-799-5517, ext 112
Fax:  803-771-4831
Email:  john@netaonline.org 
 


NETA 2008-2009 Collaborative Buy
Buyer/Licensee Profile
 

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