Media Release Order Checklist
Complete this checklist to authorize and process a media release order, including all necessary details and permissions.
Requester Full Name
*
First Name
Last Name
Requester Email Address
*
example@example.com
Requester Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization (if applicable)
Subject of Media (Person, Event, or Project)
*
Type of Media to be Released
*
Please Select
Photo
Video
Audio
Document
Other
Media Description (briefly describe the media to be released)
*
Purpose of Release
*
Please Select
Marketing/Promotion
Internal Communication
Press/News
Event Coverage
Education/Training
Other
Distribution Channels
*
Website
Social Media
Print Materials
Email/Newsletter
Broadcast (TV/Radio)
Other
Requested Release Date
-
Month
-
Day
Year
Date
Are there any restrictions or special instructions for this media release?
Upload Media File(s) or Supporting Documents
Upload a File
Drag and drop files here
Choose a file
Cancel
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Has all necessary approval been obtained for this release?
*
Yes, all approvals obtained
No, approvals pending
Signature of Requester (required for authorization)
*
Submit Checklist
Submit Checklist
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