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Media Outlet Name:*

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Circulation:*

Topic:*

Interview Specific Type*

Print
Radio
TV - Live
TV - Taped
Other Please specify :

Length of time required by Sr. Management or Thomas Kinkade*

Reporter/host - Background:*

Email Address:*

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Interview:*

Phone
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Date of interview:*

Sampling of previous interviews:*

Will digital images be needed?*

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Will photographer be required? *

Yes
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If yes, when?

Expected date interview will appear:*

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