Interview Form

Interview Request Form:

This form allows you to request an interview with Mainstreet. Simply fill out all sections of the form. Interview requests are handled regularly each weekday from 8 a.m. to 5 p.m. CST; if your interview request is extremely urgent, please call 972.267.1111 during business hours or 214.457.1398 after hours.

Your Name

Title

Media Outlet

Type of Media:

Circulation/Coverage

Address ( include city, state, zip)

Phone Number

Fax Number

Email Address

Person to Interview

Requested Date

Requested Time

Length

Interviewer

Location Preference

Topics

Date to Run

Format of the Segment

Special Notes and Information