Application to Obtain a Broadcasting Licence to Carry on a Religious (Church) Radio Programming Undertaking - Form 134

Sample form only: do not complete

This form is for reference purposes only. It is not to be completed in this format. To complete this form and submit it to the CRTC, download the MSWord format form here.

General instructions

Filing

File electronically via My CRTC Account by attaching the application to the Cover page. My CRTC Account allows you to securely submit documents to the Commission with a user ID and password. Therefore, a signature is not required when using My CRTC Account. 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 My CRTC Account can contact the Commission at 1-877-249-CRTC (2782).

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 conventions for 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.

Table 1 - Naming convention for the electronic documents
Document Electronic file name
The Covering Letter (if any) Doc1 - Cover Letter
The Application Form Doc2 - Form 134 "Application to Obtain a Broadcasting Licence to Carry on a Religious (Church) Radio Programming Undertaking"
Appendix 1A Doc3 - Appendix 1A - Supplementary brief
Appendix 2A Doc4 - Appendix 2A - Constituting Documents
Appendix 3A Doc5 - Appendix 3A - Contour Map
Appendix 3B Doc6 - Appendix 3B - Documentation - Availability of proposed Transmitter Site(s)
Each confidential document Not Web - Doc - confidential - "brief description of the document"
Each abridged version of each confidential document Doc - Abridged Version - "same description of document for which confidentiality is requested"

1. General information

Type of station: AM (  ) FM (  ) Check here if low-powerFootnote * (  )

Location of undertaking: ________________________________________________________

1.1  Identification of applicant

Not-for-profit corporation to be incorporated ( )

Not-for-profit corporation ( ) Other ( ) Specify: _________________

Name:
Address:
City:
Province/Territory:
Postal code:
Telephone:
Fax:
Email:

Contact person representing the applicant

(if there is no appointed designated representative under question 1.2)

Name:
Title:
Telephone:
Email:

1.2 Appointment of designated representative

I, _________________________, the applicant, hereby designate _____________________ 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: Example: city, province
Signature (a signature is not required when submitting electronically):

Address of designated representative:
Title:
Telephone:
Fax:
Email:

1.3 Declaration of the applicant or its designated representative

I, ___________________________________ ,solemnly declare that:

  1. I am the designated representative of the applicant named in this application brief and as such have knowledge of all matters declared therein.

  2. 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.

  3. 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.

  4. I have examined the provisions of the Broadcasting Act and the broadcasting regulations and CRTC policies relevant to this application.

And I have signed

Signature (a signature is not required when submitting electronically):
Date:

Witnessed by

Signature (a signature is not required when submitting electronically):
Name:
Date:
At: Example: city, province

1.4 Procedural request

The Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure (the Rules of 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 Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and 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:

1.5 Application

The Commission will return the application if it has not been duly completed. The onus will be on the applicant to submit a complete application that provides all of the relevant information, to identify all regulatory issues raised in the application and provide supporting documentation.

Submit a website address or email address where an electronic copy of the application may be requested:

Website:
Example: www.mycompany.com

E-mail:
Example: no-reply@no-reply.com

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

Any religious organization or foundation using the Canadian broadcasting system to solicit funds should be a charity, and should be registered as such with Canada Customs and Revenue Agency (CCRA) in accordance with the Income Tax Act (Public Notice CRTC 1993-78 - Religious Broadcasting Policy).

We agree to adhere to the guideline that stipulates that any organization that solicits funds should be a registered charity organization.

Yes (  ) No (  )

2.3

Who controls/will control the proposed undertaking and by what means?

______________________________________________________________________

Supporting document to be appended:

Appendix 2A

Copy of all constituting documents (for example, Letters Patent, Certificates and Articles of Incorporation, By-Laws, etc.) of the applicant.

3. Technical information

3.1

  1. Have all required technical documents been filed with the Department of Industry? Please note that the Commission cannot consider your application further until all documents are filed.

    Yes (  ) No (  )

  2. I hereby authorize the Commission to include as part of this application any document or correspondence filed with the Department of Industry with respect to this application.

    Yes (  ) No (  )

    If no, explain.

3.2

Provide the following technical information:

  Proposed Operation Note
Frequency   kHz for AM
MHz for FM
Channel and Class    
Transmitter power (for AM) Watts  
Maximum ERP - Effective Radiated Power

(at beam-tilt angle) (for FM)

Watts If no beam-tilt is used, provide ERP in horizontal plane
Average ERP - Effective Radiated Power

(at beam-tilt angle) (for FM)

Watts If no beam-tilt is used, provide ERP in horizontal plane
EHAAT - Effective Height Above Average Terrain metres FM only
Antenna and Transmitter site coordinates N. North Latitude
W. West Longitude
Studio Location   City and, where possible, street address

Supporting documents to be appended:

Appendix 3A

In the case of a regular power station, provide a clearly legible copy of the maps required in the Engineering Brief submitted to the Departement of Industry, and wich show the proposed coverage contours.

In case of proposal for a conversion from AM to FM, provide a comparison of the 5 mV/m AM contour with the 0.5 mV/m FM contour and of the 15 mV/m AM contour with the 3 mV/m FM contour.

In the case of a low-power AM, provide a copy of a map showing the proposed 0.5 mV/m, 5 mV/m and 15 mV/m coverage contours.

In the case of a low-power FM, provide a copy of a map showing the proposed 0.5 mV/m and 3 mV/m coverage contours.

The Commission encourages you to submit your proposed coverage area contours in a geographical information system (GIS) compatible file format (for example, .mid./.mif, .tab, .dxf, .dwg, .e00, .shp, .dgn).  Also provide the map datum and projection used. This file can be submitted electronically or on a diskette.

Appendix 3B

Documentation supporting the availability of the proposed transmitter site(s).

4. Financial operations

4.1

Establishment cost: _________________________ $

4.2

Source of funds: ______________________________________________________

5. Information on the parish

5.1

Majority religion: _________________________

5.2

Number of followers of the majority religion: _________________________

5.3

Number of followers of other religions: _________________________

6. Programming

6.1

The undertaking will provide live broadcasts of masses, weddings, funerals, baptisms and other such religious celebrations.

Yes (  ) No (  )

6.2

Minimum number of programming hours per week (all programming will be local): __________

6.3 Language(s) of programming

Languages (✓)
English  
French  
Language of Aboriginal Canadians (specify):  
Other (specify):  

6.4

  1. The licensee undertakes to adhere to the guidelines on ethics and to comply with practices 1 to 4 of Public Notice CRTC 1993-78.

    Yes (  ) No (  )

  2. Please specify how you intend to adhere to these guidelines and practices.

6.5 Conditions of licence

The licensee accepts the following Conditions of licence, which must be adhered to during all hours of the broadcast day:

  1. The licensee must broadcast programming consisting solely of religious services, with the exception of programs or program segments it produces for the purpose of ensuring balance on matters of public concern. Such programs or program segments must also adhere to guidelines (I) to (iv) contained in section III.B.2a) of Public Notice CRTC 1993-78.

    Yes (  ) No (  )

    If no, explain.

  2. The licensee shall not broadcast advertising material.

    Yes (  ) No (  )

    If no, explain.
  3. The licensee must adhere to the guidelines on ethics for religious programming set out in section IV of Public Notice CRTC 1993-78 regarding tolerance, integrity, social responsibility and solicitation of funds.

    Yes (  ) No (  )

    If no, explain.

7. Request for documents to be designated as confidential

Sections 30 to 34 of the Rules of 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:

  1. Information that is a trade secret;
  2. 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
  3. 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 Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and Procedures for filing confidential information and requesting its disclosure in Commission proceedings, Broadcasting and Telecom Information Bulletin CRTC 2010-961, 23 December 2010, for the complete process for filing confidential information.

7.1 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

Documents should be submitted in an accessible format (Broadcasting and Telecom Information Bulletin CRTC 2015-242)

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 3: Technical Information
3A - Contour Map    
3B - Documentation - Availability of proposed Transmitter Site(s)    

CRTC 134 (2015-06-11) - New - Religious (Church) Radio

Date modified: