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10/27/2011
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SWAP SHOP TV Submission Form



Name ___________________________________ Phone _________________



Email ___________________________________ Cell # __________________



How do you want to be contacted by callers: Email ___ Phone ___ Cell ____



Items being submitted for program (Limit 3 per Form)_________________________________________________



Description (Include model, S/N, size, colors, condition, or anything important to help viewers)



Item1________________________________________________________________________________

_____________________________________________________________________________________

_________________________________________________________________________$___________

Item2________________________________________________________________________________

_____________________________________________________________________________________

_________________________________________________________________________$___________

Item3________________________________________________________________________________

_________________________________________________________________________$___________



Check one or both: For Sale _______ Swap _______ Item interested in for swap ________________

_____________________________________________________________________________________



I have provided pictures _____ Number of pictures submitted ______ (min. 3) Digital ___ Copies ___



My pictures and forms were; Emailed ____ Mailed ____ Date sent __________



I would like for someone to come to my location for pictures ____ and/or Video ____ (additional charge)



Per Form Pricing: $10 (Items is less than $1,000) $20 (Items is $1,000 or less than $10,000)



$50 (Items is $10,000 or less than $50,000) $100 (Items are $50,000 or more)

Payment is for 4 weeks, one rotation per week, usually weekends. Programming repeats every 3 ½ hrs.



If you want to continue running an item, please contact us 1 week prior to your item expiring!



Payment in Advance by Money Orders or cash accepted; make Money Order to: NOW Productions



Mail All 3 forms with your payment and pictures to: NOW Productions Company, P.O. Box 2619, Valdosta, GA. 31604



I submitted a signed Broadcast Media Release and Limited Liability Form: yes ___ no ___ If you

have any questions please call David Neck at 229-460-3966 or Email dnecknow@hotmail.com



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