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Contact Channel 21

Mr. Jonathan Krawchuk, Station Manager Channel 21 105 North Main St., Suite 103 Culpeper, VA 22701
Telephone:	540.825.2447
Fax:	540.825.2704
Email:	info@culpepermedia.org
Website:	www.culpepermedia.org

Culpeper Media Network welcomes your comments and feedback. This form also includes sections for Message Board Requests and for Film Requests. Please fill out all parts of the form as completely as possible. Please include your contact information (name, email address, etc.) so that a Culpeper Media Network representative can contact you if necessary.

***Please note, our server for submissions is currently down, please send inquires to: "info@culpepermedia.org". Thank you and sorry for the inconvenience.***

*required fields
Name*
Organization
Address 1
Address 2
City
State
Zip
Telephone
Fax
Email Address *
Message or Feedback 500 character max.

FOR CHANNEL 21 MESSAGE BOARD ANNOUNCEMENTS
If you have an event announcement that you would like to run on the Channel 21 Message Board, please complete the following section. While we cannot accomodate every request, we will do our best to serve as many community groups and organizations as possible. Click here to see a Message Board sample.

Announcement* 250 character max.
Announcement Dates*	Start Finish

To submit a file (.jpg, .bmp,.pdf, .gif only) for the Channel 21 Message Board, please make sure you send it seperately by e-mailing info@culpeper21.com. Make sure to include your contact information above so that a representative may contact you with any questions.


FOR "FILM REQUESTS"
If you would like the Channel 21 staff to film your event, please complete the following form. While we cannot accomodate every request, we will do our best to serve as many community groups and organizations as possible.

Event Title*
Date and Time of Event*
Length of Event*
Brief Description of Your Event* 250 character maximum