(Live - Current) Media Request for Interview (Staff use only) Organization Info Name Name First Name First Name Last Name Last Name Title Email for media contact Phone type LandlineCell Phone for media contact Organization Type of media Website/URL Broadcast or Print Geographic Area What is the Audience Reach? Event Info Event/Program/Publication Name What is the format of the interview/program? How long should the discussion last? What is the full duration of the interview (including off camera/air holding time)? What is the interview start time and date? For a print statement, how many words are requested? Who will be interviewed? Has the event been finalized? Staff Info Email for staff submitting this request What ASALH representative confirmed the final date? How did the request come in? Date request was received What is the deadline for a response? Captcha Submit If you are human, leave this field blank.
