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Lausanne 2010INTERVIEW REQUEST FORM:

This form allows you to request an interview with a representative of Lausanne 2010. 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


Address ( include city, state, zip)


Phone Number


Fax Number


Email Address


Client
Lausanne 2010

Person to Interview


Requested Date


Requested Time
  

Length


Interviewer


Location Preference


Topics


Date to Run


Format of the Segment


Special Notes & Information





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