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Interview Request Form

2. Name*

3. Email Address*

5. Phone Number*

6. Media Outlet*

8. What is the topic of your story? If you can share the questions you have please include them.*

10. What is your deadline?*

12. When would you like to conduct the interview?*

14. What type of interview are you conducting*

    1. Phone
    2. Face to Face
    3. On Camera

16. Is this for a class assignment*

    1. Yes
    2. No

18. Which media outlet do you represent?*

    1. Bobcat Update
    2. University Star
    3. KTSW 89.9
    4. KXAN
    5. KVUE
    6. KEYE

    1. KTBC
    2. KENS
    3. WOAI
    4. KSAT
    5. KABB
    6. Other

20. If other please list.

22. When will the story be printed/aired?*
    When will the story be printed/aired?

    When will the story be printed/aired?

Leave This Blank:


24. Submit

* indicates a required field