Media Interest Form
Please fill out the form below and our team will be in touch regarding your media credentials for the I Am Youth Leadership Summit.
I AM YOUTH LEADERSHIP SUMMIT
Tuesday, June 28 | Community College of Philadelphia
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Name of the media outlet and focus of the publication
*
What type of outlet do you represent?
*
Please Select
Magazine/Print
Radio
Blog
Social Media Influencer
Television
Audience Reach
Demographic of your audience
Geographical market of your audience
Will you feature this event on your outlet
*
Yes
No
Estimated date article/post will be published
-
Month
-
Day
Year
Date
Is there anyone specific you’d like to meet with/interview?
Submit
Should be Empty: