Media Request Form

* Indicates required field

Name *

First

Last

Phone *

Name of the Organization you work for or, if independent, the media organizations you hope to pitch to: *

Email *

What is the story you are hoping to tell? *

What are the specific ways you would like to interact with us for your story? *

What other parties have you spoken to or do you plan to speak to for this story? *

What is the estimated length and format of the piece you hope to produce? *

What is other work you might have done that we could look at? *

Are you willing to allow us to review any direct quotes for accuracy prior to publication? *

Thank you for your interest. We will get back to you as soon as we can. If you have a specific timeline you are working with, please let us know.

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Ajo SamaritansPO Box 793Ajo, AZ 85321The Ajo Humanitarian Aid Office is open Fridays and Saturdays 9am to 12 noon