Visiting Media Form

This form helps us understand your needs and better prepare for your visit. Please complete & return it at least two (2) weeks prior to your visit, so that we may process any/all of your requests. Freelancers are asked to forward a copy of their letter of assignment to our offices.

* Required fields

*First Name:

*Last Name:

*Phone #: Ext:

Cell #: Ext:

*Email:

*Language spoken: French
English
Other

When do you plan to visit us?

*Arrival Date:

*Number of days:

Media

*Job Title:

*Media Name:

*Address:

*City:

*Province/State:

*Postal Code:

*Type of Media:

*Field:

*Website:

*Target Market:

*Target Audience:

*Distribution/Airing Schedule:

*Publication/Airing Date:

*Time (if applicable):

Privacy Policy
The personal information contained in this form will remain confidential and will only be used to prepare your visit at Le Massif de Charlevoix.