Media Project Request Form printable pdf download

Media Project Request Form

MEDIA PROJECT REQUEST FORM

Name of Organization: ___________________________________

Contact Person: ______________________________________

Contact Number: _____________________________________

Contact E-mail: ______________________________________

Objectives of the project

Synopsis of the project

If possible, provide links to websites that give a perspective on the organization and/or

previous projects worked on

1. _________________________________

2. _________________________________

3. _________________________________

4. _________________________________

List the names, titles or expertise of CSC staff/inmates you would like to interview or film

1. ___________________________________

2. ___________________________________

3. ___________________________________

4. ___________________________________

5. ___________________________________

Date(s) and times of filming

Start date and time ____________________________

End date and time _____________________________

Deadline _____________________________

Media Project Request Form