Community Media of Staten Island

2025 VOLUNTEER PRODUCER INFORMATION FORM

Become a Member!

For the first time in 2025, Community Media of Staten Island is introducing an annual membership. Membership is for producers and any community member that wishes to support our mission of providing Public Access television to the Staten Island community. Memberships are an important way for producers and the community to support our mission as cable revenue continues to decrease. Annual membership is $50 and can be paid by cash or check made out to Staten Island Community Television Inc. We thank you for your contributions.

Name

First Name

Last Name

Address

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Address 2

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Email

WE COMMUNICATE THROUGH EMAIL & PHONE ONLY

PLEASE PROVIDE TITLE OF PROGRAM THAT YOU PRODUCE OR CREW:

DATE OF LAST PRODUCTION :

*****For CMSI Staff Only*****

Payment

ID Number