CLIENT INTERVIEW FORM
Company Name
*
Client Name
Segment paid for by:
*
Client, 3rd party (provide name), n/a (not applicable)
AE Email (Sales Executive or Station Point of Contact's email)
*
this email will get a copy of the form submitted
Account Executive Name
*
NEW CLIENT (NO AE)
Amanda Corey
Christa Scott
Cathlene Snyder
Ivan Paramanandam
Laura Pearce
Lorri Dunn
Mandy Moore
Paula Phillips
Shaun McGrath
Tim Sanders
Lucas Tingley
Luke Knight
Name of Account Executive
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company Social Media (List as many or "None")
*
Social Media Links
What URL landing page would you like for your QR Code?
Example: https://www.mywabashvalley.com/gdl/
Company Bio
*
Website
*
If none, please confirm
Shoot Location
*
Shoot Date
*
-
Month
-
Day
Year
Date
Shoot Time
*
1
2
3
4
5
6
7
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9
10
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12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Is The Client Bringing Props
*
Are there any accommodations needed for guests?
*
Who will be interviewed? Title?
*
Will you be bringing any video or prior footage that we may be able to use?
Yes or No
Client/ Advertiser Email
If Different From Form Entry Email
On Screen Phone Number
-
Area Code
Phone Number
Topic of discussion and why?
*
Areas of Interest to Discuss
Does the client have any must ask questions?
*
Items/Areas for video
When is the best time to reach you with questions?
Would you like a copy of the story sent to you via email or hard copy delivered? (Please Specify)
Would you like a copy of the story sent to you via email or hard copy delivered? (Please Specify)
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*
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