Long Island Convention & Visitors Bureau and Sports Commission

Your Name:

Title:

Address:

City:

State:

Zip:

Country:

Phone:

Fax:

Email:

Please provide this information so we can confirm your assignment.

Are you traveling and/or working on assignment? Yes No

Outlet Name:

Phone:

Email:

Recent Writing URLs:
If you are not on on assignment, please provide URLs for recently published writing with your byline or fax copies to (631)xxx-xxxx.

Outlet Website Address:

Outlet Circulation/ Audience Size:

Coverage Area:

Publication/ Broadcast Frequency:

Address:
(if different from above)

City:

State:

Zip:

Country:

Confirmed Arrival Date:

Confirmed Departure Date:

Will you need a Long Island hotel? Yes No

If yes, will your story mention the hotel(s)? Yes No

Will you accept press rates, if necessary? Yes No

If yes, what range?

Name/Titles of People in Your Party:

Describe your planned story:

Special interests in your story:
(e.g. dining, family, seniors, shopping, spas)

Television Ad

Magazine/Newspaper Ad

Radio Ad

Internet Search Engine

Friend or Colleague

Link from Another Website