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Interview Request Form
Interview Request With:
Requested by:
Position:
Company/Program:
Address:
Postal:
Telephone:
Cell:
Email:
Date of interview:
Time:
Location/# to Call:
Interview Length:
5 mins
10 mins
15 mins
20 mins
On Air:
Live
Tape
How Long Needed:
5 mins
10 mins
15 mins
20 mins
Will Appear/Air Date:
Images Requested:
Beta
B&W
JPG
DUBS
Comments:
High-resolution images available upon request
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