Media Req./Assist. Form

Press Room

Alliance Signature Partners of Destination DC:

Journalist Information
*Name
Address
Address2
City
State/Province
Country
Zip/Postal Code
Telephone
email

Media Outlet Information:
*Name
(if you work for multiple publications, please answer according to the outlet for which you're currently researching	Newspaper Magazine Web Guidebook Television Radio Student/Consultant/Researcher
Circulation
Audience Demographics
Frequency of publication/broadcast
Geographic Coverage Area
Projected Publication Broadcast Date
*Story Angle/Subject
*Deadline

Type of Assistance Requested (check all that apply):	Press Kit Image Request b-roll Fact-checking or story research Statistics/travel trends Itinerary assistance Add me to your media list
Are you planning to visit DC to research your story?	Yes No
Would like a representative of our communications team to call you or email your directly to discuss your needs	Yes Preferred Day & time if any; Telephone number, email address or IM address, if different from above: No
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