Title of project or name of company/publication Please include: mailing address, phone/fax, e-mail.

Dates of visit

Participant(s) Please include: full name, professional status, complete contact information

Editorial policy Describe how this effects any degree of sponsorship of trip.

Audience demographics and circulation numbers

Feature content/story line/theme

Commitment to publish/broadcast Describe degree of commitment secured in advance of trip (i.e. assignment letter, etc.) and estimated date of feature appearance.

Advertising value of feature Please include in Canadian dollar amounts.

Accomodation assistance Required: Yes No

Type of accomodation: Hotel B&B Other

Room: Double Second

Smoking: Yes No

Number of rooms required:

Transportation Air transportation:

Rental vehicle(s): (Please list drivers)

Specific Services requested Describe assistance required to fulfill media visit objectives. Include the following: attractions/sights/activities required/interviews, etc.

Additional comments

Email

Security Code: Please enter the 5 digit code into the box

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