Media Database Addition
If you wish to receive VIFF updates and news, please fill out all required fields to be added to the database.
Email address *
Do you want to receive VIFF media information by email? (By responding yes, you are granting us permission to add you to our media database.) *
First Name *
Your answer
Last Name *
Your answer
Job Title *
Your answer
Media Outlet (if freelance, list assigning media and editor's name and email) *
Your answer
Complete Mailing Address *
Your answer
Website *
Your answer
Twitter Handle
Your answer
Instagram Handle
Your answer
Phone (direct)
Your answer
Phone (mobile) *
Your answer
Media Type *
Frequency *
Circulation or Reach *
Your answer
Language *
Required
Have you covered VIFF Before? *
What updates or news are you interested in receiving? *
Required
What types of stories do you publish / produce? Please check all appropriate boxes. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service