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MizzouRec Services & Facilities Media Access Request Form

MizzouRec Media Contact:

Emily Bach
(573)882-5375
bache@missouri.edu

In order to fully accommodate your request, please submit form by 4 pm the day before you plan on being in the facility. All requests for Saturdays, Sundays, and Mondays must be submitted by 4 pm Friday.

Reporter Name:

Photographer/Videographer Name:

Requestor Contact Information

Email address:

Phone number:

Media Outlet/Organization:

Requested Date and Time of Access: at :

Date and Time of Broadcast or Publication: at :

Story/Assignment Summary:

If this is a request to complete student

Class:

Instructor:

Upon Approval

Credentials will be available for pick‐up from the Membership Desk at the east entrance.
Photo ID must be provided upon arrival and will be returned upon departure.
Department media agreement must be signed upon arrival.