Request Form
Name of Person Requesting Ad:
Day Time Phone #: Start Date: End Date:
Which Level: Number of Weeks: Total Amount:
Message:

 

 

 

 

 

 
Level 1 - FEES: free
Community meeting Church club meetings
Church services School functions
Level 2 - FEES: $ 3 / 7 days
Birthdays Graduations
Anniversaries Mother's/father's day
Memorial messages All holiday greetings

(Standard screen no additional Cost)
(Additional Cost: $1.00 per image scanned)
Level 3 - FEES: $ 5 / 7 days
Garage Sales Las Vegas nights
Festivals Night at the races
Fish Fries Bingo
Pirohy Sales Chinese auctions
Spaghetti dinners
Level 4 - FEES: Business Commercials
  1. Generic Scroll -
    • Weekly - $10.00
    • Monthly - $20.00
    • 6 months - $100.00 (Includes 1 free month & one update to original)
    • 1 year - $180 (3 free months & three updates to orginal)
  1. Custom Scroll  -
    • Pricing for option A plus set up fee
Mail this form & your money to:
Allow 14 days for mailing.		 Campbell Community TV
280 Sixth Street
Campbell, OH   44405