Media Plan Request Form

A media plan request template — give planners the objectives, budget, audience and channels they need to build a media plan that hits the goal.

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Description

A media plan is only as good as the brief it’s built from. This media plan request form gives planners the objectives, budget and audience they need, so the plan they build is aimed squarely at the campaign’s goal.

It captures the brand and the campaign objectives, the total media budget, and the primary objective. It takes the channels you’re considering, the target audience, the campaign start and end dates, and the key markets or geographies.

Use it to brief a media plan before the planning work begins. A clear request means a plan built around the real objective and audience, not the planner’s best guess. Customize the fields, add your branding, and embed it on your site or share a link in minutes.

Form fields

Everything the Media Plan Request Form above collects — 12 fields, so you can see exactly what it captures before you make it your own.

Request a Media Plan

Brand / client
Short Answer
What are the campaign objectives?
Long Answer
Total media budget
Short Answer
Primary objective
Dropdown
Which channels are you considering?
Multi-Select
Who's the target audience?
Long Answer
Campaign start
Date
Campaign end
Date
Key markets / geographies
Short Answer
Your name
Name
Email address
Email
Contact number
Telephone

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Template FAQs

Common questions about the Media Plan Request Form — what it captures, when to use it, and how to make it your own.

What is a media plan?

A media plan sets out where a campaign’s budget will be spent across channels to reach its audience and hit its goal. This request form gives planners the objectives, budget and audience they need to build that plan, so it’s aimed at the right outcome from the start.

What should a media plan request include?

This form captures the brand and campaign objectives, the total media budget, the primary objective, the channels you’re considering, the target audience, the campaign start and end dates, and the key markets or geographies for the plan.

When should you request a media plan?

Early, once the campaign’s objectives and budget are known and before media is booked. Giving planners a clear brief up front means they can build the right channel mix around the audience and goal, rather than reworking the plan as missing detail comes to light.

Who requests a media plan?

Usually the campaign or account lead, submitting it to the planning team. The form captures the objectives, audience and budget, so planners have what they need to build a plan and a clear point of contact to confirm decisions with.

What’s the difference between a media plan and a media buy?

A media plan decides where the budget should go across channels to hit the goal; a media buy is the actual purchasing of that inventory. This form requests the plan — the strategy — which the buying then delivers once it’s agreed.

Is this media plan request template free to use?

Yes, completely free. Add or remove fields, adjust the channels to fit your planning, and restyle it to your brand, then embed it on your site or share a link — no coding needed. A free Fun Forms account lets you collect requests.

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