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Character Interview Request

Your Name:

First Name

Last Name

Your Email Address:

Your Phone Number:

(###)

###

####

Date of Interview:

YYYY

Time of Interview:

Hour

Minute

Second

Type of Interview:

Topic of Conversation:

Please provide your interview questions in advance here:

Name of person conducting the interview:

First Name

Last Name

Who should we contact if we need to cancel or adjust the interview?

What else would be helpful to you to make this interview work for your media?