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PUBLICITY & DESIGN REQUEST FORM 
                                                                               

                                                            Today’s Date ___________________    Mgr. Approval _________________ 
                                                                                                                                            

                                  Submitted By __________________________________    Direct Phone # ________________________   
                                                                                                                                                     
                                       Branch/Dept. ____________________    Received by ComRel on ___________________________ 
                                    
                                                                                               DESIGN  
         PRESS RELEASE                             DEADLINE __________________ Materials will be ready 3 weeks prior to deadline 
                                                    
 

         E‐NEWSLETTER LISTING                      TARGET AUDIENCE ____________________________________________________   
 
                                                   TYPE/S OF DESIGN NEEDED (poster, tabletent, bookmark, etc. ______________ 
DEADLINE: The 10th of the month  
before the month your event                        _________________________________________________________________________ 
is scheduled. (Jan. 10 for a Feb. event) 
                                                   QUANTITY _______    DISTRIBUTION AREA/S ____________________________ 

     
     
    Title _____________________________________________________________________________________________________________ 
     

    Date _____________________________________________________________________________________________________________ 
     

    Time/s ___________________________________________________________________________________________________________ 
     

    Location  _________________________________________________________________________________________________________ 
     

    Age Requirements  ________________________________________________________________________________________________ 
     

    Sign‐up/Reservation Requirements  _________________________________________________________________________________ 
     
    Detailed Description: 
    Please be very specific and descriptive. The more information you provide, the more interesting the publicity will be. Feel free to 
    attach additional information, facts, quotes and/or pictures.  
    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 

    __________________________________________________________________________________________________________________ 
                                                                       

                               PLEASE SEND THIS FORM TO COMMUNITY RELATIONS  
                                   & PROVIDE A COPY TO YOUR PROGRAM LIAISON.                               AW, 1.07 
      
                                                                                            

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Publicity Design Request Form

  • 1. PUBLICITY & DESIGN REQUEST FORM    Today’s Date ___________________    Mgr. Approval _________________    Submitted By __________________________________    Direct Phone # ________________________           Branch/Dept. ____________________    Received by ComRel on ___________________________    DESIGN   PRESS RELEASE       DEADLINE __________________ Materials will be ready 3 weeks prior to deadline      E‐NEWSLETTER LISTING   TARGET AUDIENCE ____________________________________________________      TYPE/S OF DESIGN NEEDED (poster, tabletent, bookmark, etc. ______________  DEADLINE: The 10th of the month   before the month your event   _________________________________________________________________________  is scheduled. (Jan. 10 for a Feb. event)  QUANTITY _______    DISTRIBUTION AREA/S ____________________________      Title _____________________________________________________________________________________________________________    Date _____________________________________________________________________________________________________________    Time/s ___________________________________________________________________________________________________________    Location  _________________________________________________________________________________________________________    Age Requirements  ________________________________________________________________________________________________    Sign‐up/Reservation Requirements  _________________________________________________________________________________    Detailed Description:  Please be very specific and descriptive. The more information you provide, the more interesting the publicity will be. Feel free to  attach additional information, facts, quotes and/or pictures.   __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________  __________________________________________________________________________________________________________________    PLEASE SEND THIS FORM TO COMMUNITY RELATIONS   & PROVIDE A COPY TO YOUR PROGRAM LIAISON.                               AW, 1.07