Media Request Form

First Name*

Last Name*

Email*

Phone*

Are you a STUDENT reporter?*

Yes
No

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*

Select All
General Information/Press Release
Interview (Phone)
Interview (In-Person)
Photo/Video
Other

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. Please note we require 72 hours upon receipt of this form to process your request.

Interview Questions*

Please list the questions you would like to ask. This will help our departments gather the needed information promptly.

Campus Info

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