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Traditional Media

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Dates

Arrival Date*:

Arrival Time*:

Arrival Time

Departure Date*:

Departure Time*:

Departure Time

Projected Publication Date*:

Contact Information

First Name*:

Last Name*:

Publication/Station*:

Zip/Postal Code*:

Country*:

Primary Phone*:

Email*:

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Outlet Details

Media Type*:

Media Type

Publication Frequency*:

Publication Frequency

Circulation*:

Distribution Area*:

Distribution Area

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Coverage Details

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Website URL*:

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Past Visits

Will this be your first time visiting?*:

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If no, where have you visited?*:

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Press Trip Participants

Please understand that assistance is provided for members of the working media. Host locations are not always able to accommodate spouses, children, photographers and visitors accompanying working journalists.

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Number of Children*:

Ages of Children*:

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Emergency Contact Information (someone not traveling with you)

Name*:

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Relationship*:

Requested Arrangements

Lodging*:

Lodging

Region*:

Region

Physical Restrictions*:

Dietary Restrictions*:

Additional Materials Requested*:

Additional Materials Requested

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