2BPR Journalist Accommodations Request Form

Thank you for your interest in traveling with our clients. In order for us to submit a request for their consideration, we ask that you please fill out this form (one form per property/visit request). This will provide us with important information about your media outlet(s), story angles, and special needs during your stay.

Please note: Due to the volume of requests we receive and other factors such as time zone differences and clients’ work and travel schedules, we ask for your patience as it can take up to two weeks to receive confirmation on media accommodation requests. An advance planning time of six weeks or more to plan and arrange your trip is highly recommended.

Full Name

PrefixFirst NameMiddle Name or InitialLast Name

Byline (if different than above)

First NameLast Name

Media Outlets

Your Title/Position

Email

Confirmation Emailexample@example.com

Cell Phone Number

Format: (000) 000-0000.

Office Phone Number

Format: (000) 000-0000.

Physical Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

AT WHICH HOTEL OR RESORT ARE YOU REQUESTING A STAY?

*Please include the destination country after the property's name

Desired Date of Arrival

MonthDayYear

Desired Date of Departure:

MonthDayYear

*Please Note: The number of room nights our clients provide media varies based on many factors. In general, a maximum of 1-2 complimentary or media rate nights may be offered if your outlet and story angle meets their criteria. Additional nights may be offered at the full rate or a media rate. Thank you for considering this as you make your accommodations request.

Will you be traveling with a guest?

Guests' Name

PrefixFirst NameMiddle or InitialLast Name

Guests' Birth Date:

Date

Number of rooms requested:

Type of rooms requested:

Other

Do you (or your guest) have any allergies or dietary restrictions?

If YES, please list all specific food allergies and/or dietary restrictions below:

Nuts, Soy, Shellfish, etc.

Transfers requested?

Arrival Flight:

Departure Flight:

Special Requests/Activities pertaining to your story (spa, tours, dining etc.)

Confirmed Assignment/Story Angle:

Expected Date of Publication:

Title of Publication/Outlet:

Type of Outlet:

Other

Print Circulation:

Print Outlets

Broadcast Listener/Viewership:

Broadcast Outlets

Outlets' Website Address:

Number of Unique Visitors per Month:

Advertising Value of Proposed Coverage

Additional Assignment/Story Angle & Publication/Outlet:

Expected Date of Publication:

Title of Publication/Outlet

Type of Outlet:

Other

Print Circulation:

Print Outlets

Broadcast Listener/Viewership:

Broadcast Outlets

Outlets' Website Address:

Number of Unique Visitors per Month:

Facebook Page:

# of followers

Twitter Handle:

# of followers:

Instagram Handle:

# of followers:

Special Needs: Please list any additional special requirements you may have to make your trip more comfortable (e.g., physical challenges that may require special medical care /accessibility / transportation assistance, etc.)

In Case of Emergency Contact:

First NameLast Name

Relation:

Phone Number

Format: (000) 000-0000.

Terms of Responsibility

Agreed To & Accepted By:

Journalist Signature / Date