MEDIA AND PUBLICATIONS LICENSE REQUEST FORM

Before completing this request, please read this form in its entirety and ensure that all questions are answered completely and accurately. All requests must be approved by the International President and/or Executive Director at Delta Sigma Theta Sorority, Inc. Please mark whether executive leadership is granted and provide proof by uploading correspondence. Any unmarked requests will be forwarded to the executive leadership before further processing.

No incomplete submission will be processed. Incomplete submissions include failure to attach manuscripts and/or proposals or detailed responses to form questions. If your form is incomplete, you will be informed and asked to revise to process.

PROCESSING TIMELINE - Delta's processing timeline can vary and start from receipt date of completed request. A typical media license request is processed within two (2) weeks whereas a publication license request is processed within three (3) weeks from receipt of a completed request. Timelines are subject to change with additional requests for clarity or information.

PUBLICATION REQUEST NOTE - Publication requests may require further from concept creation to final publication. We ask that these requests be made at the concept stage to avoid any undue delays in the publication cycle.

If you have any further questions about this process, please contact us at media@deltasigmatheta.org.

Name*

First NameLast Name

Company/Organization*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email*

example@example.com

Phone Number*

Area CodePhone Number

Publication & Airing Date (If in multiple platforms, please clarify in summary field below). *

Your media request pertains to (select all that apply):*

Television (i.e. broadcast & cable)Print Newspaper & MagazineBooks (including self-published & with publication house)Online (i.e. social media accounts, video streaming platforms, & other online publications)Other

Check Delta media needed to fulfill your project:*

Marks (i.e. Delta Sigma Theta, National Crest, Greek Letters)Photographs & Videos (i.e. Founders Portrait Photograph)Interviews with Delta LeadershipOther

Please provide project summary below. *

Upload proposal materials, including mock-ups and image files, for review. *

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