Media Request Form

First Name*

Last Name*

Email*

Phone*

Are you a STUDENT reporter?*

Please describe if this is for a CLASS, PUBLICATION, or OTHER*

PUBLICATION NAME*

Please enter the name of your publication or media outlet - If other, please type N/A.

Media Outlet WEBSITE

Select type(s) of content you are seeking*

If OTHER, please describe

To which department(s) does this apply?*

Story Topic*

Deadline*

Last possible date for an interview or receipt of content/images/etc.

Interview Questions*

Please list out the questions you would like to ask, to ensure the requested department has the necessary analytics to share with you.

Campus Info