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Media Request Form

"*" indicates required fields

* denotes a Required Field

Who would you like to Interview?*

Title Name

Name of Media Outlet:*

Brief Background of Media Outlet*

Circulation/number of viewers/listeners:*

Name of interviewing reporter and title:*

Title Name

Phone number:*

E-mail:*

Interview type:*

Interview location:*

Subject of interview:*

Sample questions:*

Justification of Request:*

Deadline:*

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U.S. Embassy and Consulate
in Nigeria

U.S. Embassy and Consulate in Nigeria