Media Request Form
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Organisation
*
What kind of content are you seeking?
*
Comment
Press Release
Interview (phone)
Interview (in-person)
Photography/Video
Other
Will the content be live, pre-recorded or written?
*
Live
Pre-recorded
Written
Is there a specific LBSU officer or member of staff that you would like to speak to?
*
Yes
No
Please specify the officer/staff member you would like to speak to:
*
Story Topic:
*
Please list the questions you intend to ask so the relevant staff member can provide accurate information:
*
Please give your deadline date for the content so we can respond in a timely manner:
*
-
Month
-
Day
Year
Date
Email
example@example.com
Submit
Should be Empty: