Media Request - Crew Celebrity
Sign in to Google to save your progress. Learn more
Choose the celebrity you'd like to interview *
Name of Journalist
*
Phone number 
*
Email address
*
Name of publication/media outlet
*
Valid link to publication/media outlet
Type of interview
*
Format of interview
*
Required
Date/Deadline
*
Insert two options
Location of the interview (if applicable*)
Link to Location
Expected duration of interview
*
Topics of Discussion/Questions
*
Needed Material
Expected date of publishing 
*
MM
/
DD
/
YYYY
Medium on which the interview will be published/broadcasted
*
Required
Comments/ Special requests
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.