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Press Trip Request

Personal Information
First Name:
Last Name:
Job Title / Company:
Address:
Address Line 2:
City, State, Zip: , ,
Phone: () -
Fax: () -
E-mail Address:
About your Media Outlet
Company/Publication Name:
Circulation/Audience Size:
Geographic Area Coverage:
Frequency of Publication/Broadcast:
Type of Story Planned:
About Your Visit
Date of Arrival:
Date of Departure:
Hotel Arrangements Needed?  Yes   No
If yes, will you mention the host
hotel(s) in your story?
 Yes   No
If complimentary arrangements are not
available, will you accept Press Rates?
 Yes   No
If yes, what is your price range?
People in your Party:
Please list full names and job titles of all
those in your party. If you are the only one
in your party, leave this field blank.
Comments (Optional):
Yes, send me specials and packages
from the High Sierra Visitors Bureau