Media Request Form

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 NameLast NameSuffix
Position & Title
Example: "Executive Director of Organization LLC"
Your Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
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 CoveragePromotional VideoInternal CommunicationsExternal CommunicationsSocial Media ContentMarketing / PromotionConsultation
Target Audience*

PublicConfidentialBusinessGovernmentYouth
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 CoveragePhotography CoveragePublic Relations ConsultationProfessional Photography ServiceMarketing Design Job (Branding, Flyers, Logos)Documentary FilmShort FilmAuditory Service
Quantity Of Videos

1246
Aspect Ratios

16:9 Standard Horizontal Format (YouTube/Documentaries)9:16 Vertical Format (Reels/Stories)1:1 Standard Social Media Format (Square for Feeds)
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*

MonthDayYear
Additional Dates
If there are multiple dates.
Event / Filming Start & End Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Setup Time Required?

YesNo
Only If Setup Time is Required.

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Rain Date

MonthDayYear
Requested Delivery Date

MonthDayYear
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*

IndoorOutdoorBothVirtually
Access Requirements

Security ClearanceParkingLoad-in InstructionsNone
Permits / Approvals

YesNoUnsureNone
Talent & Interviews
Will people be featured on camera?

YesNoUnsure
If Yes, Please List Names / Titles / Roles
Interview Questions Needed?

YesNoClient Will Provide
If Client Provides Questions, Please List Them Here:
Media Release Agreements

YesNoClient Will Provide
Branding & Creative Direction
Itineraries/Programs/Script/Talking Points Upload

Please provide any written scripts, talking points, or interview questions if applicable.
Cancelof
Logos Upload

Please provide any logo graphics of the organization, business, entity, etc that would be needed for branding purposes.
Cancelof
Brand Guidelines Upload

Please provide any branding guidelines you may have such as a branding book/PDF with Hex Color Codes, Typography Preferences, etc.
Cancelof
Tone & Style

FormalInspirationalHigh-EnergyDocumentaryCorporateCinematic
Visual References Upload

Please provide any upload examples OR share URL links if applicable.
Cancelof
Post-Production Specifics
Editing Requirements

Captions / SubtitlesMotion Graphics / Lower ThirdsMusic LicensingVoiceover
File Delivery Method*

OneDriveExternal Hard Drive / Flash DriveGoogle DriveSocial-Ready ExportsEmail Link / AttachmentsOther
Review All Submitted Information
Does Name's Blue Media have permission to post or use content for marketing and promotional materials?*

YesNo
Did you check your submission for ALL grammar, spelling, and specific detail errors? Request can be marked for resubmission.*

YesNo
Select Method of Payment*

Invoice (Multiple Options)Cash Only
Should be Empty:

Media Request Form

Client & Project Identification

Project Scope & Objectives

Service Request Type

Timeline & Scheduling

Location & Logistics

Talent & Interviews

Branding & Creative Direction

Post-Production Specifics

Review All Submitted Information