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.

Name

This field is for validation purposes and should be left unchanged.

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