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Mt. Hood Territory offers assistance to qualified media intending to provide coverage of the destination, though resources and staff time are limited. Interested parties should complete a media assistance request form detailing their specific needs at least four (4) weeks prior to intended travel dates. Mt. Hood Territory reserves the right to decline any request.

DATES

Date of Request


Arrival Date


Arrival Time


Arrival Location


Departure Date


Departure Time


Departure Location


JOURNALIST INFORMATION

Name as it appears on passport or government issued ID *


Date of Birth


Street Address


City, State, Zip Code, Country


Work Phone *


Mobile Phone *


Can we reach you on your mobile number while in The Territory?
No   Yes  

Email Address *


Best way to reach you while you are in The Territory


Are you a smoker or a non-smoker?
Non-Smoker   Smoker  

Valid Foreign Travel Health Insurance (if applicable)
No   Yes  

Allergies/Dietary Restrictions


Health Concerns/Physical Limitations


Are you a first time visitor?
No   Yes  

If not, which Mt. Hood Territory locations have you visited previously


SOCIAL MEDIA HANDLES

Twitter


Instagram


Pinterest


YouTube


Facebook


MEDIA OUTLET

Outlet Type

  TV
  Newspaper
  Magazine
  Website
  Social
  Other

Outlet Name


City, State, Country


Outlet Niche/Focus


Audience/Demographic


Circulation/Audience #


Media value of article


Assignment Secured?
No   Yes  

Estimated Length


JOURNALIST OBJECTIVE

Please select all that apply

  Reporter
  Freelancer
  Photographer
  Producer
  Blogger
  Social Media Influencer

Other:


Storyline/Angles


Request areas in Mt. Hood Territory to include in itinerary


Meeting Requests (specific individuals or organizations you would like to interview)


Sights, attractions and activities you would like to experience


Preferred Itinerary Style
Action Packed: Set appointments and interviews throughout the day with some time for exploring on my own
   Best of Both: A few set appointments each day with ample time to explore on my own
   Solo Explorer: Hotel nights booked but mostly suggested meals and attractions that I will explore on my own
  

Other (please explain)


Do you plan to include accommodation listings or reviews in your coverage?
No   Yes  

Do you plan on including Mt. Hood Territory's website, mthoodterritory.com?
No   Yes  

TRAVEL ARRANGEMENTS

Number of Media


Number of Non-Media


Bringing a Photographer?
No   Yes  

Travel Host
I need a travel host   I would prefer to travel on my own  

If complimentary accommodations are unavailable, would you accept a media rate?
No   Yes  

Mode of transportation to Mt. Hood Territory
Car   Flight   Train  

Transportation while in The Territory
Rental Car (book on your own)   Rental Car (need booked)  

Room Preference (if any)


Additional Comments



  * Please Enter All Required Fields
HIGHLIGHTS
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