Application to Obtain a Broadcasting Licence to Carry on a Community Programming Service(1) - Form 115
General instructions

Applicants should consult the Commission's Policy Framework for Community-based Media set out in Public Notice CRTC 2002-61 dated 10 October 2002.
⁽¹⁾	A licence to operate a Community Programming Service will only be issued in cases where a cable licensee does not provide a community channel, or does not operate a community channel in accordance with the provisions of the Community Channel Policy, as set out in Public Notice CRTC 2002-61 dated 10 October 2002.

1.	Filing
	File electronically via Access Key by attaching the application to the Cover page. Access Key allows secure transmissions to the Commission and also authenticates your identity. Therefore, a signature is not required when using Access Key. Applicants who file their application in this manner are not required to submit a hard copy of the application and its related documents.
	Applicants who cannot send their application electronically with the Access Key service or who need further information relative to the CRTC processes can contact the Commission at 1-877-249-CRTC (2782).
2.	Instructions
	The following questionnaire is in HTML format and may be downloaded to the word processing software of your choice. This enables you to complete the downloaded questionnaire by inserting your response in bold letters immediately following the question. You may add lines to the tables if necessary but do not alter or delete any text from the questionnaire.
	The application must be divided into sections as set out in the questionnaire, and include the numbered questions followed by the corresponding response. Responses must be provided, at a minimum, in a size 10 font.
	Naming convention for the electronic documents
	The following documents should be submitted as separate electronic documents using the naming convention specified below. The document number (Doc#) indicates the ascending order in which the documents should appear on the public file.
	The Covering Letter (if any) - Doc1 - Cover Letter dated ____ The Application Form - Doc2 - Form 115 "Application to Obtain a Broadcasting Licence to Carry on a Community Programming Service(1)" Appendix 1A - Doc3 - Appendix 1A - Supplementary Brief Appendix 2A - Doc4 - Appendix 2A - Constituting documents (or drafts) Appendix 4A - Doc5 - Appendix 4A - Program Description (table) Appendix 4B - Doc6 - Appendix 4B - Block Program Schedule Each confidential document - NOT WEB - Doc# - CONFDOC - "brief description of the document" Each abridged version of each confidential document - Doc# - ABRIDGED VERSION - "same description of document for which confidentiality is requested"
	The Commission may return the application if it has not been duly completed or if the required technical documentation has not been filed with Industry Canada. The onus will be on the applicant to submit a clear application that provides all of the relevant information, identifies all regulatory issues raised in the application and provides supporting documentation.

Canadian Radio-television and Telecommunications Commission

Form 115 - Application to Obtain a Broadcasting Licence to Carry on a Community Programming Service

1. General information

LOCATION OF UNDERTAKING: ________________________
1.1	IDENTIFICATION OF PROPOSED LICENSEE (hereinafter the applicant)
	Individual ( )	Company to be incorporated ( )
	Company ( )	Other ( ) Specify: ____________________

	NAME: ADDRESS: Facsimile: Email: CONTACT PERSON REPRESENTING THE APPLICANT (if there is no designated representative under question 1.2) NAME: TITLE: TELEPHONE:
1.2	Appointment of designated representative I, _________________________, the applicant, hereby appoint _____________________ as my designated representative for and on my behalf and in my name to sign, file and complete (if necessary) an application with the Canadian Radio-television and Telecommunications Commission and to sign and file a reply with respect thereto and I do hereby ratify, confirm, and adopt as my own act, such application and all replies made thereto. Date: At: Signature (not required if submitting electronically): ADDRESS OF designated representative: TITLE: TELEPHONE: Facsimile: Email:
1.3	DECLARATION OF THE APPLICANT or its designated representative
	I, ___________________________________ SOLEMNLY DECLARE THAT:
	a)	I am the designated representative of the applicant named in this Application Brief and as such have knowledge of all matters declared therein.
	b)	The statements made in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) to the best of my knowledge and belief true in all respects.
	c)	The opinions and estimates given in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) based on facts as known to me.
	d)	I have examined the provisions of the Broadcasting Act and the broadcasting regulations relevant to this application.
	AND I HAVE SIGNED Signature (not required if submitting electronically): Date: WITNESSED BY Signature (not required if submitting electronically): Name (Printed): Date: At:
1.4	Location(s) where the application may be examined Set out the applicant’s website address or, if the application is not posted on their website, the email address where an electronic copy of the application may be requested: Website: Example: www.mycompany.com Email: Example: no-reply@no-reply.com
1.5	Procedural request The Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure allow an interested person to request that the Commission exercise a power under the Rules of Procedure or change the Rules of Procedure for a specific proceeding (sections 5 and 7). This is generally called a procedural request. You may consult the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and the Guidelines on the CRTC Rules of Practice and Procedure, Broadcasting and Telecom Information Bulletin CRTC 2010-959, 23 December 2010, for more information. Is the applicant requesting that the Commission make an exception to its Rules of Procedure in the treatment of this application? Yes ( ) No ( ) If yes, please indicate which section of the Rules of Procedure you wish to vary, and provide a detailed rationale as to why this request should be granted :

2. Ownership

2.1

Complete the following table relating to the directors and officers, including the Chief Executive Officer, of the applicant. Please note that all sections must be completed.

DIRECTORS AND OFFICERS
Name	Complete Home Address	Citizenship	Position Held	Directors: Date and Term of Appointment

2.2

The Community Channel Policy states that licensees of community programming services will be not-for-profit organizations, the structure of which will provide for membership, management, operation and programming primarily by members of the community at large. Explain how the applicant will fulfill this provision of the policy.

SUPPORTING DOCUMENT TO BE APPENDED:
APPENDIX 2A	A copy of all constituting documents (for example, Articles and Certificates of Incorporation, By-Laws, Partnership or Trust Agreement) relating to the applicant (provide draft documents where a corporation is not yet incorporated).

3. Financial operations

3.1	In accordance with Generally Accepted Accounting Principles (GAAP), complete a summary of the estimated annual revenue and expenses for each 12-month period, ending 31 August, of the proposed licence term.
	THE FIRST YEAR OF OPERATION WILL BE: __________

	YEAR 1	YEAR 2	YEAR 3	YEAR 4	YEAR 5	TOTAL
REVENUE ($000)
Cable licensee funding
Sponsorship payments
Government funding
Non-government funding (such as grants and fund-raising campaigns, etc.)
Other (Specify):
TOTAL REVENUE
OPERATING EXPENSES ($000)
Programming
Technical
Sales, Advertising and Promotion
Administration and General
TOTAL OPERATING EXPENSES
NON-OPERATING EXPENSES ($000)
Depreciation
Interest
Other Adjustments - Expenses (income)
TOTAL NON-OPERATING EXPENSES
TOTAL EXPENSES
Estimated pre-tax income (loss)
Provision for Income Taxes
NET INCOME (LOSS) AFTER TAXES (for broadcasting operations only)

3.2	Provide a projected statement of pre-operating costs for the period prior to the commencement of operation.
3.3	Provide a pro-forma statement of changes in financial position relating to the proposed service for each of the first five years of operation.
3.4	Provide a detailed listing of all basic underlying assumptions upon which the financial projections in question 3.1 above have been prepared, including expected inflation rates and whether the projections have been using current or constant dollars.

4. Programming

The following section relates to the programming obligations set out in the Commission's Policy Framework for Community-based Media in Public Notice CRTC 2002-61 dated 10 October 2002.

Applicants are reminded that, except where the Commission has provided otherwise in a condition of licence, applicants must also comply with the regulatory requirements set out in the Broadcasting Distribution Regulations (the regulations), as amended from time to time.

For the purpose of answering the following section: in accordance with the regulations, a "broadcast week" refers to the total number of hours devoted to broadcasting during the 126-hour period extending from 6:00 a.m. to midnight, for seven consecutive days beginning on Sunday.

4.1

The Commission has set out the provisions and requirements for community channels operated by terrestrial distribution undertakings in its Community Telvision Policy, Broadcasting Regulatory Policies CRTC 2010-622, 26 August 2010, and in Community Television Policy - Correction, Broadcasting Regulatory Policy CRTC 2010-622-1, 13 September 2010.

Please confirm that the licensee will adhere to the applicable provisions (i.e. requirements, expectations and/or encouragements) set out in Broadcasting Regulatory Policies CRTC 2010-622 and 2010-622-1, by condition of licence.

Yes ( ) No ( )

If no, specify the requirements, expectations and/or encouragements you propose to amend with a detailed rationale in support of any such amendment, including, where appropriate, financial evidence, and propose wording for alternative requirements, expectations and/or encouragements
For the licensee that elect to distribute a community channel, outline how you are operating fully in accordance with the provisions set out in the Community Television Policy, particularly with respect to :
1. Roles and objectives
2. Local community television programming
3. Community programming
4. Access programming
5. Accountability and reporting

For licensees that provide community programming in the greater Toronto, Montréal and Vancouver areas, outline how you reflect the various geographic communities within your licensed areas in these urban centers, and which commitments you have undertaken.

4.2

LANGUAGE OF PROGRAMMING

The principal language of programming will be: ____________

4.3	HOURS OF BROADCAST The applicant UNDERTAKES to broadcast ______ hours per broadcast week and not to increase or decrease this number by more than 20% without seeking Commission approval.
4.4	LOCAL COMMUNITY TELEVISION PROGRAMMING
	NOTE: Licensees who provide community programming must devote not less than 60% of the programming aired each broadcast week to the broadcast of local community television programming. Local community television programming is defined as consisting of programs, as defined by the Broadcasting Act, that are reflective of the community, and produced by the licensee in the licensed service area, or by members of the community from the licensed service area. Programs produced in another licensed service area within the same municipality will also be considered local community programming. The applicant UNDERTAKES to devote at least 60% of its programming during each broadcast week to local community television programming.
			YES ( )	NO ( )
	If NO, specify proposed level and provide justification for the proposed exception.
4.5	OTHER SOURCES OF PROGRAMMING
	a)	The applicant proposes to broadcast programming originating from other community channels and/or community programming services:
			YES ( )	NO ( )
		If YES, specify the originating community channels/community programming services.
	b)	The applicant expects to broadcast a maximum of : (hrs:min) of programming in a broadcast week from other community channels/community programming services.
	c)	For applicants who propose to broadcast programming from other community channels and/or community programming services, outline how these programs will complement your local programs.
4.6	ACCESS PROGRAMMING
	NOTE: Class 1 and Class 2 licensees must devote a minimum of 30% of the programming aired during each broadcast week to the broadcasting of programs produced by individuals or groups within the community served by the undertaking, either assisted or unassisted by the licensee. Where the requests for access exceed the 30% minimum requirement, Class 1 and Class 2 licensees shall make available a minimum of 50% of the programming aired during each broadcast week to the broadcasting of access programs. Class 3 licensees must make available a minimum of 30% of the programming aired in each broadcast week to the broadcasting of programs produced by individuals or groups within the community served by the undertaking, either assisted or unassisted by the licensee.
	a)	For applicants proposing to operate a community programming service distributed by a CLASS 1 or CLASS 2 cable undertaking: The applicant UNDERTAKES to devote at least 30% of its programming during each broadcast week to programs produced by individuals or groups within the community served by the undertaking, and make available a minimum of 50% of the programming aired during each broadcast week to the broadcasting of access programs.
			YES ( )	NO ( )
		If NO, specify proposed level and provide justification for the proposed exception.
	b)	For applicants proposing to operate a community programming service distributed by a CLASS 3 cable undertaking: The applicant UNDERTAKES to make available a minimum of 30% of the programming aired during each broadcast week to the broadcasting of access programs.
			YES ( )	NO ( )
		If NO, specify proposed level and provide justification for the proposed exception.
4.7	VOLUNTEER PARTICIPATION
	Please describe your proposed measures to:
	a)	facilitate community access to programming;
	b)	promote the availability of training throughout the community; and
	c)	provide for the ongoing training and supervision of those within the community wishing to participate in programming.
4.8	SERVICE TO THE HEARING IMPAIRED
	a)	Will you install a Telecommunications Device for the Deaf (TDD) at the proposed undertaking?
			YES ( )	NO ( )
		If NO, provide reasons.
4.9	SERVICE TO THE VISUALLY IMPAIRED
	What plans do you have to meet the needs of the visually impaired, for example, providing audio descriptions of programming?

SUPPORTING DOCUMENTS TO BE APPENDED:
APPENDIX 4A	Provide a copy of a weekly programming schedule (Block Schedule) as a sample of the type of programming to be broadcast. This schedule must identify the origin of programs using the codes set out in Appendix 4A. A sample of a Block Schedule is as follows:

Sample of a block schedule format

APPLICANT: _____________________________________________________________
LOCATION: ______________________________________________________________

HOUR	SUNDAY	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY	HOUR
06:00								06:00
07:00								07:00
08:00								08:00
09:00								09:00
10:00								10:00
11:00								11:00
12:00				SAMPLE				12:00
13:00								13:00
14:00								14:00
15:00								15:00
16:00								16:00
17:00								17:00
18:00								18:00
19:00								19:00
20:00								20:00
21:00								21:00
22:00								22:00
23:00								23:00

5. Request for documents to be designated as confidential

Sections 30 to 34 of the Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure set out a process by which parties to Commission proceedings may file information on the record of a public proceeding in confidence.

A party filing information can “designate” it as confidential at the time it is filed with the Commission (section 31) if it falls into one of the following categories:

Information that is a trade secret
Financial, commercial, scientific or technical information that is confidential and that is treated consistently in a confidential manner by the person who submitted it; or
Information the disclosure of which could reasonably be expected :
1. To result in material financial loss or gain to any person;
2. To prejudice the competitive position of any person; or
3. To affect contractual or other negotiations of any person.

At the time that the party files the information it designates as confidential, it must provide an abridged version of the document along with an explanation of how the information falls into a category of information listed in section 31. The party must provide a detailed rationale to explain why the disclosure of the information is not in the public interest (section 32(1)).

The confidential version of the document must be filed separately and must be marked “CONFIDENTIAL” on each page. If the document is filed electronically, each file containing confidential information must include “CONFIDENTIAL” in the file name.

The abridged version of the document and the reasons for the designation of information as confidential will be placed on the public record of the proceeding.

Please consult the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and the Procedures for filing confidential information and requesting its disclosure in Commission proceedings, Broadcasting and Telecom Information Bulletin CRTC 2010-961, 23 December 2010, for complete process for filing confidential information.

5.1 Request for documents to be designated as confidential

Are you requesting for some information to be designated as confidential?

Yes ( ) No ( )

If yes, you must provide a detailed rationale to explain why the disclosure of the information is not in the public interest :

Book of supporting documents

APPENDIX NUMBER AND NAME		APPENDED (Yes or No)	E-FILED (Yes or No)
SECTION 1: GENERAL INFORMATION
1A	Supplementary Brief
SECTION 2: OWNERSHIP
2A	Constituting documents (or drafts)
SECTION 4: PROGRAMMING
4A	Block Program Schedule

This document is available in alternative format upon request.
CRTC 115 (2011-07-15) - New - Community Programming Service
version française disponible

***End of Document***

Application to Obtain a Broadcasting Licence to Carry on a Community Programming Service(1) - Form 115 General instructions

General instructions