Media Media Media Name * First Name Last Name Email * Phone * (###) ### #### Name of Media Organization * ABC CBS CNN FOX MSNBC NBC PIX Thirteen Other Please note: Maximum people = two (2) from one outlet Name of Assigning Editor / Producer * MM DD YYYY What is your budget? Are you a Freelance Journalist? If so, please provide the name of Assigning Editor / Producer Name of Assigning Editor / Producer * Are you willing to do a cover story on the Black Authors Festival? Yes No Please provide e-mail address and direct dial of Assigning Editor / Producer E-mail Address * Direct Number to Your Assignment Editor/Producer * (###) ### #### Are you a part of a professional organization? * Yes No What is the name of your professional organization? * If your answer was no, type N/A How did you hear about us? Website Newspaper Radio Other Message * Thank you!
