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'Culturally Incorrect,' Rod Parsley

INTERVIEW REQUEST FORM:

This form allows you to request an interview with Rod Parsley regarding "Culturally Incorrect." Simply fill out all sections of the form. Interview requests are handled regularly each weekday; if your interview request is extremely urgent, please call (972) 267-1111.

Your Name


Title


Media Outlet


Type of Media


Circulation/Coverage


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Phone Number


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Email Address


Client
"Culturally Incorrect " / Rod Parsley

Person to Interview


Requested Date


Requested Time
  

Length


Interviewer


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Topics


Date to Run


Format of the Segment


Special Notes & Information