Media Request Form
Thank you for requesting a service from Name's Blue Media! Please be sure to fill out all required sections so we may capture complete project intelligence, clarify deliverables, define timelines, and align stakeholders before production begins.
Client & Project Identification
Primary Contact
*
First Name
Last Name
Suffix
Position & Title
Example: "Executive Director of Organization LLC"
Your Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Website of Organization
www.example.com
Project Scope & Objectives
Project Title
*
Provide a short title for the project
Project Summary
*
What are the details of the project? Please provide as much information as possible.
Primary Objective
*
Event Coverage
Internal Communications
External Communications
Social Media Content
Marketing / Promotion
Consultation
Other (Specify)
Target Audience
*
Public
Confidential
Business
Government
Youth
Key Message or Call-to-Action
What are the desired outcomes of this project? What should viewers think, feel, or do? Outcomes should be specific, measurable, achievable, realistic, and time-bound.
Service Request Type
Primary Service
*
Event Coverage
Photography Coverage
Public Relations Consultation
Professional Photography Service
Marketing Design Job (Branding, Flyers, Logos)
Documentary Film
Short Film
Auditory Service
Quantity Of Videos
1
2
4
6
Aspect Ratios
16:9 Standard Horizontal Format
9:16 Vertical Format
1:1 Standard Social Media Format
File Format
*
MP4 (4K, 2K, 1080p)
JPG (Standard for Images/Flyers/Thumbnails)
PNG (Higher resolution Image For Images/Flyers/Thumbnails)
PDF (Highest Quality for Print; CMYK)
WAV (Highest Audio Format)
Timeline & Scheduling
Requested Production Date
*
-
Month
-
Day
Year
Date Picker Icon
Additional Dates
If there are multiple dates.
Event / Filming Start & End Time
*
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Setup Time Required?
Yes
No
Only If Setup Time is Required.
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Rain Date
-
Month
-
Day
Year
Date Picker Icon
Requested Delivery Date
-
Month
-
Day
Year
Date Picker Icon
Hard Deadlines
If there are multiple dates, please provide all dates and times. Grant deadlines, broadcast schedules, premieres, etc.
Location & Logistics
Provide Location Name(s)
*
Provide the name of where the event or project will take place. If this project is virtual and does not have an address, please mark this as "N/A".
Provide Address
*
Provide the address of where the event or project will take place.
Additional Locations
If there is more than one location, please provide the list of addresses of the locations (and name if available of locations). Provide if there is parking and where specifically.
Select Where Location Takes Place
*
Indoor
Outdoor
Both
Virtually
Access Requirements
Security Clearance
Parking
Load-in Instructions
None
Permits / Approvals
Yes
No
Unsure
None
Talent & Interviews
Will people be featured on camera?
Yes
No
Unsure
If Yes, Please List Names / Titles / Roles
Interview Questions Needed?
Yes
No
Client Will Provide
If Client Provides Questions, Please List Them Here:
Media Release Agreements
Yes
No
Client Will Provide
Branding & Creative Direction
Itineraries/Programs/Script/Talking Points Upload
Browse Files
Drag and drop files here
Choose a file
Please provide any written scripts, talking points, or interview questions if applicable.
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of
Logos Upload
Browse Files
Drag and drop files here
Choose a file
Please provide any logo graphics of the organization, business, entity, etc that would be needed for branding purposes.
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Brand Guidelines Upload
Browse Files
Drag and drop files here
Choose a file
Please provide any branding guidelines you may have such as a branding book/PDF with Hex Color Codes, Typography Preferences, etc.
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Tone & Style
Formal
Inspirational
High-Energy
Documentary
Corporate
Cinematic
Visual References Upload
Browse Files
Drag and drop files here
Choose a file
Please provide any upload examples OR share URL links if applicable.
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Post-Production Specifics
Editing Requirements
Captions / Subtitles
Motion Graphics / Lower Thirds
Music Licensing
Voiceover
File Delivery Method
*
OneDrive
External Hard Drive / Flash Drive
Google Drive
Social-Ready Exports
Email Link / Attachments
Other
Review All Submitted Information
Does Name's Blue Media have permission to post or use content for marketing and promotional materials?
*
Yes
No
Did you check your submission for ALL grammar, spelling, and specific detail errors? Request can be marked for resubmission.
*
Yes
No
Select Method of Payment
*
Invoice (Multiple Options)
Cash Only
Submit
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