Media Release Time Request Form
Request authorization for a specific time slot to conduct media activities such as interviews, filming, or photography.
Requester Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization or Affiliation
*
Type of Media Activity
*
Please Select
Interview
Filming/Recording
Photography
Press Coverage
Other
Subject of Media Release (Person, Event, or Organization)
*
Purpose or Description of Media Activity
*
Requested Date and Time for Media Activity
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Media Activity
*
Special Requirements or Requests (e.g., equipment, access needs)
Additional Comments or Notes
Submit Request
Should be Empty: