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Madison City Channel 12
Duplication Request Form

 
      
  
                                                                                                     

Title of Program:




Do you need the whole program or just a segment?
whole program  segment 
If you chose "segment, please describe as clearly as
possible, what segment(s) you need:


Will you be providing a tape? 
yes no

Do you need us to send you the tape? (Additional shipping and handling fees will apply.)
yes no

Questions:


Thank you, we will contact you once the tape is ready or if we have any questions.