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Get TBN Second Chance for Your Facility

Facility Application Form

Please provide the following information to apply for a free TBN Second Chance installation in your correctional facility.

If you do not know an answer to a particular question, please indicate on the form. We recommend you consult with your media or engineering department to complete this form as it will expedite the processing of your application.

Each correctional facility is responsible to expedite the approval process necessary to receive a free TBN Second Chance installation. For multiple facilities, a separate application is required for each location.

Tell Us About Your Facility

Name of your Facility or Organization:

Facility Type:
Federal
State
Private
Juvenile
Re-entry/aftercare facility
Other

Security Level (indicate more than one):
Minimum
Medium
Maximum
Other

Number of Inmates/Residents/ Patients:
   Men
   Women
   Juveniles

Facility Address:
City:
State:
Zip:
   

Requester/
Contact Person:

Title:
Email:
Phone:
Fax:
   
Engineer/
Media Contact Person:
Title:
Phone:
Fax:

Tell Us About Your Facility’s Current Television Distribution System

What network(s) are you interested in receiving for your facility?
TBN
JCTV
The Church Channel
TBN Enlace USA
All Networks

Do you currently have TBN in your facility? Yes No

Is your facility currently wired for video distribution? Yes No

If wired for distribution, how many television sets are connected?

Number of TV Media/Headend Rooms (where the video equipment is located that serves facility)?

Does the facility receive local cable channels? Yes No
If yes, please give name of cable system (please indicate if this is a correctional cable provider):

Does the facility have a broadcast antenna installed?
UHF
VHF
None

Does the facilty receive satellite broadcasts? Yes No
If yes, what satellite systems are installed?
DirecTV
DISH Network
C-band

Do you have approval from the warden or other authority to implement TBN Second Chance?
Yes
No
In process
I am the authorized requestor

Name of Warden or Authorized Representative:

Any other information, we should know?

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