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2. First Name*
3. Last Name*
5. Company Name*
6. Phone Number
8. Address*
10. Address cont'd
12. City*
13. State*
14. Zip*
16. Email Address*
17. Blog/Website URL
19. Facebook Page
20. Instagram Handle
22. Other Social Media Channels
24. Media Trip Information (List the focus of your media trip request)*
26. Requested Travel Dates*
28. Assistance: (Outline assistance needed to fulfill media visit objective)*
30. Commitment to Publish or Broadcast (Describe level of commitment, estimated delivery and size of story)*
32. List Two References With Contact Information
34. First Name*
35. Last Name*
37. Contact Email
38. Contact Phone
40. First Name*
41. Last Name*
43. Contact Email
44. Contact Phone
46. Guidelines Agreement*

    By checking this box I understand that filling out this application does not guarantee that the Calvert County Department of Economic Development will agree to host me. I also certify that I have read and agree to the Calvert County Travel Writer Guidelines as published.

    1. I understand
48. Electronic Signature*

    Please sign your full name acknowledging that all of the above information is accurate and you have thoroughly read the Travel Writer Guidelines.

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50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

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