Name*

Title

Your email*

Phone Number*

Is the person completing this worksheet going to be an on-air guest?
YesNo

Business/Organization Phone Number (The number viewers should call.)

Website

Additional Guest Name(s)

Talking Points:
Tell us at least 3 things you would like us to talk about during your segment.

Props:
Props/Demonstrations and/or pictures/video are encouraged for an appearance on KELOLAND Living. Think of this as “show & tell.” Do you have a demonstration you can do on-site?

Images & Graphics:
Please provide us with a .jpg or .png file of your company’s or organization’s logo. You may also attach any other images or logos below. (JPG, PNG, GIF, PDF, or ZIP files accepted - 5MB file size limit per image - photos in horizontal/landscape style are much better than vertical/portrait photos.)

Links to Images/Graphics: If your images or graphics are too large to attach, please contact us for a file sharing link.

If you are sending multiple images (5+), please4 indicate how you would like these visual elements used during your appearance:
Put images into a video slide show. (Each image is on-air for 5 seconds)Put images into separate on-screen graphics. (There is no time limit as to how long the image is on-air)

Videos or Music:

Videos are too large to attach to this form, please contact us for a file sharing link.
Media Use Waiver:
By checking this box you attest that you own the images and video supplied and agree to permit KELOLAND Media Group to use and disseminate on its website and social media channels. (i.e.-Facebook, Twitter, Instagram, YouTube, etc.)
I Agree

Need a FileSharing link to send us your Logo/Pictures/video?
Instructions & link will be sent to you via email.
Yes