News Media Site Visit Information

First Name

First name as it appears on your ID. Please add your middle initial or name here if it is on your ID.

Last Name

Last name as it appears on your ID.

Street Address, including city, state and zip code

What is your t-shirt size?

Go-to coffee (or tea) order:

Please list any dietary restrictions and/or food allergies.

Special Accommodations

Please let us know of any special accommodations needed for your travels to/from Jacksonville and/or during your time in Jacksonville.

Who are you most excited to see when you get home?

Emergency Contact Name

Please provide the first and last name of an emergency contact.

Emergency Contact Phone

Please provide the best phone number to reach your emergency contact at.

Preferred start date of visit

Preferred end date of visit

Will you fly or drive to Jacksonville?

Fly

Drive

Birthdate

Enter your birthday - month, date and year - if flying.

Known Traveler Number

Enter your Known Traveler Number, if applicable.

Would you like Visit Jacksonville's assistance in securing hotel accomodations?

Yes

If assistance is not needed, where will you be staying?

Will you mention the hotel in your story?

Yes

Are others traveling with you? If YES, please include the name and age of each. If NO, please type "N/A"

Media/Outlet Information

Are you visiting on assignment?

Yes

Media Outlet Name or Name(s) of Targeted Publication(s)

Story Angle or Focus

What’s your biggest pet peeve when covering a city or event?

Activity Preferences/Requests While in Jax

Activities Requested/Things You'd Like to Do

Examples include Timucuan Preserve, Ritz Theatre and neighborhood tours.

Are you interested in trying Visit Jacksonville's Trail Mix during your visit?

Please check each trail you're interested in.

Black Heritage Trail

Jax Ale Trail

Jax Coffee & Donuts Trail

Mayport Shrimp Trail

Special Requests or Other Ways Visit Jacksonville Can Help

Morning or Night Person?

Up & at 'em bright and early

Night owl

Sweet or Salty?

Sweet tooth

The saltier, the better

How Do You Take Notes?

Classic notebook & pen

Digital note taker

What’s your favorite way to unwind after a long day?

Anything else we should know?

By checking this box, you understand that your email address will be added to our email distribution list and you will receive occasional emails from Visit Jacksonville. You may unsubscribe at any time.

Yes, please add me to your email distribution list.

By checking the below boxes and submitting this online form, I acknowledge I have read and agree to the following:

Expenses will only be reimbursed for business class airfare or mileage (if driving personal vehicle), rental car, gas for rental car, hotel, attraction and tour tickets, and meals up to a maximum of $2500 for media person only. This includes the airfare purchased/coordinated by Madden Media or the DMO.

Any expenses above the $2500 maximum, including those for any guest(s) traveling with media, are the responsibility of the media or guest traveling with media.

I understand and acknowledge that expenses for guests will not be reimbursed.

The final travel reimbursement amount will be based on paid receipts submitted. Expenses incurred will not be reimbursed without proper proof of purchase and gratuity greater than 20% will not be reimbursed.

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News Media Site Visit Information Form

Contact Information

Tell Us About You

Emergency Contact

Travel Details

Media/Outlet Information

Activity Preferences/Requests While in Jax

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