| Name* |
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| Title |
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| Address Line1 |
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| Address Line2 |
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| Town/City |
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| State/Province |
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| Zip/Postal Code |
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| Country/Region |
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| Phone* |
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| Fax |
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| Mobile phone or number you can be reached at while on-island: |
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| Email* |
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| Publication/Program |
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Circulation/Viewers/
Listeners |
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| Demographic Profile |
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| Date/Issue Segment or Article to Appear |
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Words/Pages/Minutes
in the story |
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Will there be online support for the story? What is the website:
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If it is a broadcast program, what is the style of your show (hosted, documentary, covering multiple locations, etc.)
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What is the expected monetary value for this coverage (e.g. comparatively, this coverage would be worth $$ as purchased advertising)
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| Dates of Visit to Big Island |
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How many people are in your party and what are their titles?
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| Will you need photos or video to be supplied by BIVB for your story? |
Yes No
(If so, please be aware that any visuals that are published must be credited to the Big Island Visitors Bureau and the photographer.) |
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In which (Hilo, Kailua-Kona, Waimea, Kohala Coast, etc.) destinations throughout the Big Island will you be staying overnight and on what dates?
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What are you requesting BIVB and its members host as complimentary or for a media rate (accommodations, activities, rental car, etc.):
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What can the media cover without hosting assistance from BIVB and its members (air transportation, meals, accommodations, ground transportation, etc.):
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Please list all communication you have already had regarding this visit with BIVB members, on-island vendors, CVBs or other contacts to arrange accommodations, activities and/or tours:
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