Request for Coverage

Please use the following form to request BevCam coverage of a community event.

Name *

First

Last

Email *

Phone

Name of Organization/Sponsor

Requesters relationship/position with organization *

Event Name *

Reason for Request/Relevance to Community *

Description of Event *

Date / Time of Event *

Date

Time

Location of Event *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Live Stream this event? *

• No, I would not like to LIVE stream this event
• Yes, I am interested in LIVE streaming this event
• I am not sure

Describe Audio Needs – i.e. will there be a podium? audience participation? live music?

Will there be a computer presentation?

• Yes
• No
• Maybe/Not Sure

Available for BevCam distribution on BevCam channels?

• Yes
• No
• Maybe

Permissions/Rights acquired by all participants?

• Yes
• No
• Working On It

Submit