Dolores Huerta Foundation Interview and Meeting 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 meeting or an 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 an interview or meeting with Dolores Huerta, or another person affiliated with her or the DHF, please provide the following information.

Name of the contact person
Your answer
Name of the organization
Your answer
Telephone number of the contact person
Your answer
Alternate telephone number for the contact person
Your answer
Email address for the contact person
Your answer
Fax number
Your answer
Website
Your answer
Postal mailing address of the contact person and organization
Your answer
Other people the DHF should be in communication with for this event: travel agent, producer, photographer, etc. (If applicable, please provide name, telephone number, and email address.)
Your answer
Date and time of interview/meeting
MM
/
DD
/
YYYY
Time
:
Length of interview/meeting
Hrs
:
Min
:
Sec
Deadline to confirm interview/meeting
MM
/
DD
/
YYYY
Time
:
Is your request limited to Dolores Huerta, or would another representative from the DHF organization, or a family member be acceptable?
Type of interview/meeting
Briefly describe the type of interview/meeting here.
Your answer
Additional interview/meeting participants - Please list names, if applicable.
Your answer
If this is a television/radio interview, what is the date and time it will air?
MM
/
DD
/
YYYY
Time
:
Please list additional dates and times it will air.
Your answer
If this is a television/radio interview, on which channels/stations will it be broadcast?
Your answer
Language the interview/meeting 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.
Intended audience for this interview/meeting
Your answer
Location of interview/meeting - Please list the physical address and a description of the venue, if applicable.
Your answer
Special instructions/guidelines for travel, entrance, or parking at this location
Your answer
Will the cost of travel and lodging be provided?
Your answer
Can travel and lodging for an assistant/travel companion be provided?
Your answer
Would you or your organization be willing/able to provide a copy of the final product of the interview to the Dolores Huerta Foundation?
If the answer is yes, please send it to Juanita Chavez, Communications and Media Coordinator, PO Box 2087 Bakersfield, CA 93303, jchavez@doloreshuerta.org
Please send any contributions to the Dolores Huerta Foundation at P.O. Box 2087, Bakersfield, CA 93303, or consider becoming a monthly donor. You can sign up at www.doloreshuerta.org
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms