Interview Request Form for Media and Class Projects

Interview Needed By: *

Month

Day

Year

Name *

Email *

Phone Number *

Are you a CU student? *

Yes

No

Interview for *

Please indicate what class and professor *

ex: JRNL 1000, John Doe

If other, please explain:

When are you available? *

Please note that we are unable to accommodate interview requests outside of regular business hours.

Interview Topic (please be specific) *

Interview Questions *

Please include the questions you will be asking during the interview

If you would like to speak to a representative from a specific department, please indicate which one

Collegiate Recover Community (CUCRC)

Counseling and Psychiatric Services (CAPS)

Health Promotion

Medical Services

Office of Victim Assistance (OVA)

Recreation Services

Faculty and Staff Assistance Program (FSAP)

Preferred Type of Interview *

Phone

In-person

Video

Audio

Additional Comments

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