Please provide the name of the person who will be the contact for this request, if different
Please provide the name of the person filling out this form.
Please provide the name of the organization who is generating this request (The origin of request is usually the company or publisher who is filling out this form).
If different, please provide the name of the publication or organization who will be publishing the final work (the magazine, newspaper, TV show, radio program, etc.)
DATE AND DEADLINE INFORMATION
Please choose the date the interview needs to take place.
PLEASE USE PST. If the interview must happen at a specific time (I.e.: live on radio) please specify, using Pacific Standard Time (Seattle).
What date do you need us to respond to this request by?
TYPE OF REQUEST
Please specify the type of request and who you would like interview.
Please check all that apply. If OTHER, please note below.
Please provide some more information on the background of the publication and specifics of this request.
Please give us a brief overview of the request.
When possible we prefer to do written or phone interviews, and can also do video interviews in studio remotely.
Please provide as much detail as possible on the publication, their views and goals and when available the name of the reporter or interviewer of the stipulated Publication/Organization.
Please provide us with as much statistical information on the publication or program as possible (age, gender, type of reader/viewer, religious views, # of readers/viewers, etc.)