Media Request Form COCA Marketing & Communications Request A 4-6 week time period is requested for completion of requests. If materials have to be printed/completed out of the office more time should be allotted to complete. Questions? Contact Jennifer at JKirlin@cocaberks.org. Name of requestor First Last Email* Is this request for the Berks Opioid Coalition (SOS Berks)? Yes No Project Deadline* Type of Project (Select all that apply)* Eblast Event Marketing Graphic Design (Flyer creation, brochure edit, etc.) Online Payment (Please provide details) Photography/Videography Press Release Social Media Re-order of material Special Project (Please provide details) Training Registration Website Edits Other Do you need an edit to existing materials or new materials made from scratch?(Please select)Edit to existing materialNew materialDescribe who, what, when, where and why*Describe your project including printing requirements, URLs, budget, dates, sponsors, grants, etc.File Drop files here or If you have any files (logos, flyers, etc.) to accompany your request, please upload them here.