Contact Information

Full Name (per photo ID):

Preferred Name:

Pronouns:

Birthday

Title/Position:

Email:

Cell Phone:

Address

Emergency Contact Name:

Emergency Contact Phone Number:

Special Food Requirements:

Health Concerns/Physical Limits:

Trip Information

Arrival Date:

Departure Date:

Please list number of guests, and who they are in relation to you.

Number of Guests:

Preferred Itinerary Type

I need my coffee- start my schedule after 10am.

I need ample time each day to explore on my own. Please allow 3 hours of "my time" each day.

Beauty-rest is a priority. My days end by 8pm.

Action-pack it. Start early, end late. I go stir crazy with free time.

Have you visited Durham before?

Yes

Do you agree to make every effort to make each appointment on your itinerary?

Yes

Publication Information

Are you on assignment?

Yes

Media Outlet(s) you contribute to::

Outline assignment details and story angles

Anticipated Coverage:

Has your publication written about Durham before?

Yes

Links to Sample Coverage/Similar Stories

Assigning Editor:

Assigning Editor Email:

Do you plan on taking video?

Yes

Do you plan on taking photos?

Yes

Story Goals/Interest

Other Interests:

Social Media

Facebook:

Twitter:

Instagram Handle:

What platforms will you be posting on while you're here?

Travel Arrangements

How will you be arriving/departing?:

Lodging Accommodation (Number of Nights):

Please include details below.

Have you already booked accomodations/attractions/experiences?:

Lodging Accommodations

Hotel

Personal

N/A

Lodging Assistance Requested

None

Complimentary

Media Rate

N/A

Additional Information

What interests you about Durham as a destination?:

Is there anything specific you would like to do or see in Durham?:

Please note specific interview requests.

Preferred travel style: