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
*
NEW CLIENT (NO AE)
Amanda Corey
Cathlene Snyder
Mandy Moore
Paula Phillips
Shaun McGrath
Brooke Turpen
Tim Sanders
Rick Semmler
Kassidy Glassburn
Sydney Bordner
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
*
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Month
-
Day
Year
Date
Shoot Time
*
1
2
3
4
5
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:
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
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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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