This form is to be completed by college representatives only.
After filling in information about your college, check
each box that corresponds to a telecourse that you would like Maryland Public
Television to license on your behalf. Checking all three boxes is equivalent
to an annual license. After you have made your selections and verified them,
please click on the "Submit this Form Online" button below to forward
your form directly to MPT. If you prefer, you may print these pages, circle
your choices, and mail the form to:
| Christina Bildstein College of the Air Maryland Public TV Owings Mills, MD 21117 |
Please note that if you choose to print and mail your information, you should not use the space at the bottom for additional information. Use an additional sheet of paper if necessary.