Dolores Huerta Foundation Media Interview Request Form
Thank you for your interest in Dolores Huerta and the Dolores Huerta Foundation for Community Organizing. To learn more about our work, please visit our website at www.doloreshuerta.org

If this is a request for an event other than a media interview, please fill out the Dolores Huerta Foundation Event Participation Request Form at https://docs.google.com/forms/d/1CNrVjGPGFLGW64o_42Iw4nDVU5vE1hcUpDOg92TxVWo/viewform?usp=send_form

To request a media interview with Dolores Huerta, or another person affiliated with her or the DHF, please provide the following information.

Email address *
Media Outlet *
Your answer
Contact Name *
Your answer
Contact Information (i.e. phone, address, fax, website etc.) *
Your answer
Proposed Interview Date & Time
MM
/
DD
/
YYYY
Time
:
Alternate Proposed Interview Date & Time
MM
/
DD
/
YYYY
Time
:
Other General Proposed Date & Time
Your answer
Length of Interview *
Hrs
:
Min
:
Sec
Deadline to Confirm Interview *
MM
/
DD
/
YYYY
Time
:
Who would you like to interview? *
Required
Type of Interview *
Required
Briefly describe the topic of the interview. *
Your answer
Language the interview will be conducted in. *
Dolores and most of the DHF staff are bilingual in English and Spanish. One of the DHF board members is fluent in American Sign Language.
Required
Location of interview - Please list the physical address and a description of the venue, if applicable.
Your answer
Additional Information
Your answer
Join DHF Social Justice Network at JoinDHF.org. Support the community organizing work of DHF at Give2DHF.org
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.