CelebWorx Media Request
Please fill out all questions for your request to be processed. Please note, each request will be processed in order and submitting multiple responses will not expedite your request.   By submitting your email address, you consent to receive email notifications from CelebWorx regarding the status of your request, future client announcements and more. 
Sign in to Google to save your progress. Learn more
Name of Media Outlet *
Media Email Address *
Media Phone Number
Media Inquiry Type  *
Please tell us about your viewership. Link to your platforms, social media outlets, and provide subscriber and reach numbers for your publication and each social media platform. Missing information will not allow us to process your request. *
Which Client(s) are you interested in? *
What is the Date of your interview request?
What is the Time of your interview request?
Is your interview request taking place at an in-person event? If so, please name the event. 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of CelebWorx. Report Abuse