Influencers & Content Creators Media Form

Contact Information

First Name*:

Last Name*:

Address*:

City*:

State/Province*:

Zip/Postal*:

Country*:

Phone*:

Fax:

Cell Phone:

Email*:

Is it okay for us to contact you via email?*:

Yes No

Media Information

Are you an Influencer and/or Content Creator?:

Influencer
Content Creator

Attach Media Kit and/or Rate Card:

Editorial Interests*:

Do you plan to share your experience and/or your final report on a social media site?:

Yes No

Please provide your Twitter Username.:

Please provide your Facebook URL.:

Please provide your Instagram URL.:

Please provide your TikTok URL.:

Please provide your LinkedIn URL.:

Can we interact with you via Social Media while you are in Baton Rouge:

Yes No

Itinerary Information

Confirmed date of arrival:

Confirmed date of departure:

Are there any place(s) in particular you want to visit?:

Room Information

Accommodations needed?:

Yes No

If yes, will you mention the hosting accommodation in your in your story?:

Yes No

If complimentary accommodations are not available, will you accept press rates?

Preferred Hotel:

Number of rooms needed:

Number of double rooms::

Number of single rooms::

Number of people in party:

Names, Titles and E-mails of People in Party:

Smoking Preference:

Do you have any dietary restrictions?:

If you have arranged for accommodations, please name the property::

Interview Preferences

If you need specific interviews arranged, please list their names:

Is a Translator needed?

Emergency Contact Information

Emergency Contact Name:

Emergency Contact Relationship:

Emergency Contact Home Phone:

Emergency Contact Cell Phone:

Privacy Policy

We are committed to protecting your personal information and maintaining your trust. This Privacy Policy explains the types of personal information we collect and store through our website, how we use it, what we do not do with it.

I have read and agree to the privacy policy.

* Indicates a required field.

Hurricane Francine Update

Hurricane Francine Update

Sign up for our E-Newsletter

Get your free Welcome Guide

Get the latest scoop from The Red Stick Blog

Influencers & Content Creators Media Form

Contact Information

Media Information

Itinerary Information

Room Information

Interview Preferences

Emergency Contact Information

Privacy Policy