Appearance/Recording Date

Person Providing Information*

Title

Your email*

Phone Number*

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

Sanford Health Department or Organization Name

Sanford Phone Number (The number viewers should call.)

Website or Dedicated Web Page URL

Guest Name(s) - Please provide guest name and job title below and their email address if available.

Talking Points:
Tell us at least 3 things you would like us to talk about during the segment. Give us as much detail as possible.

Location:
In-StudioOn LocationZoom Pre-RecordedZoom As-LiveIn-Studio & Live Zoom

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 or that you take “on the road” that enlightens potential customers? If you are bringing props or demonstration items please tell us what the items are and if you need our demonstration desk or the main set round table.

Check any additional items you'll need for your props.
ElectricityRefrigeratorFreezerHot PlateClothing RackDress FormDisplay TableDisplay RacksPedestalBowlsGlassesPlates

Additional Information:

Images & Graphics:
Please provide us with a .jpg or .png file of a logo for the Sanford department or special area logo that you would like used on air. You may also attach 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.) We can also provide you with a file sharing link to upload materials to. This will be sent in a separate email. File Sharing Instructions.

Graphic Title:
See guide on How To Build A Successful Graphic.
Image Provided? YesNo
Graphics Headline
Graphics Subhead: Sanford Health Bullet Points (Up to 5 maximum)
1.
2.
3.
4.
5.

Links to Images/Graphics: If your images or graphics are too large to attach, please upload to a file sharing service (Google Drive, Dropbox, etc.) and put the link in the field below.

Videos:

Videos are too large to attach to this form, please upload to a file sharing service and put the link in the field below. If your video is on YouTube/Vimeo please leave a link below. PLEASE SEND VIDEO RECORDED IN HORIZONTAL (LANDSCAPE) MODE! Vertical video does not look good on TV. If you need us to provide you with a file sharing link, type "YES" below. File Sharing Instructions.


If you need any assistance with sending files, please email jandrews@keloland.com.

Media Use Waiver:
By checking this box you attest that Sanford Health owns 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