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Media Service Request Form

Communications & Public Relations Services

General Information
Name*
First Last
Phone - Primary*
Phone - Other*
Email*
Request Type
- Audio Operation
- Graphic Design (Flyer/PDF)
- Marquee Message
- Photography (Event Photos/Photoshoot)
- Video Editing (Edits to prerecorded video)
- Video Equipment Operation (Powerpoint, etc.)
- Videography (Recording of an Event/Videoshoot)
- Web Design (Website update/Page Creation)
Document Upload
Drop files here or
Please upload any documents necessary to complete your request
Requestor Group*
- External Organization
- Faculty
- Staff
- Student
Student ID #*
Major
Has your advisor approved this request?*
- Yes
- No
Advisor Name*
First Last
Advisor Email*
Advisor Phone*
Event Information
Event Title
Event Date*

Specific calendar date final piece is needed
Event Start Time*

: HH

MM
Event End Time*

: HH

MM
Location*
Off Campus Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
What are the services requested for?*
- Course
- Conference
- Departmental Use
- Student Activity
- External Request
Is the event ticketed?
- Yes
- No
Admission Price
Is there promotional material available for the event?
This information can include a flyer, registration packet, logo etc.
- Yes
- No
Please upload a copy of any promotional material
Drop files here or
Additional Information
Please supply any additional information relevant to your request

CONTACT

701 W. Monroe St. Salisbury, N.C. 28144
704.216.6000
info@livingstone.edu

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Think it’s too late to apply for college admissions?

Think again.

Applications accepted through August.
Got questions? Give us a call:

(704) 216-6001

Weather Advisory:

Livingstone College is monitoring Hurricane Dorian and its effect on this area. We will advise of any changes to school operations. Stay tuned to this website and our Facebook Page @Livingstone1879.

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