News Media Site Visit Information

First Name

First name as it appears on your ID.

Last Name

First name as it appears on your ID.

Street Address, including city, state and zip code

What is your t-shirt size?

Travel & Visit Details

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 in your Group? If YES, please include the name and age of each. If NO, please type "N/A"

Activities Requested/Things You'd Like to Do

Examples include Timucuan Preserve, Ritz Theatre and neighborhood tours.

Would you be interested in visiting breweries on the Jax Ale Trail during your visit?

Yes

Please list any dietary restrictions.

Special Accommodations

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

Media/Outlet Information

Are you visiting on assignment?

Yes

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

Story Angle or Focus

Special Requests or Other Ways Visit Jacksonville Can Help

Anything else we should know?

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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 $2,000 for media person only. This includes the airfare purchased/coordinated by Madden Media.

Any expenses above the $2000 maximum, including those for any guest(s) traveling with media, are the responsibility of the media or guest traveling with media.

The final travel reimbursement amount will be based on paid receipts submitted. Expenses incurred will not be reimbursed without proper proof of purchase.

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News Media Site Visit Information Form

Contact Information

Travel & Visit Details

Media/Outlet Information