2. CIRCUIT COURT FOR PRINCE GEORGE'S COUNTY

4. 

6. Media Request Form 

   If you are a member of the media, please complete this form to help us assess your request. Thank you!

8. Date*
   Date
10. Name*
12. Title*
14. Media Outlet/Organization*
16. Email*
18. Telephone Number*
20. Medium*

    1. Print (newspaper, magazine, blog)
    2. Television
    3. Radio
    4. Digital (YouTube, website, vlog)
    5. Photography
22. Interview Type*

    1. In person
    2. Phone
    3. Virtual (Zoom, WebEx, etc.)
24. Scheduled Broadcast/Publication Date*
26. Please list planned interview questions.*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

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