Media Assistance Request

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How We Can Help

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About You

First Name:
Last Name:
Address 1:
Address 2:
City:
State:	(International visitors, select "N/A")
Zip:
Phone:
Email:

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About Your Media Outlet

Publication/Freelance:
Address 1:
Address 2:
City:
State:	(International visitors, select "N/A")
Zip:
Circulation/Audience Size:
Geographic coverage area:
Frequency of publication/broadcast:
Projected publication/broadcast date:
About Your Visit

Date of Arrival:	(mm/dd/yyyy)
Date of Departure:	(mm/dd/yyyy)
Where are you staying:
Type of story planned:
Special interests (i.e. golf, fishing, shopping, history, etc.):
Other comments/requests:

Kim Chapman, Public Relations Manager
kchapman@gulfshores.com
1-800-745-SAND
251-974-4625 (direct)
251-752-8448 (cell)