Media Request Page

For media requests including TV, print and podcast interview requests, please submit all of the details of your media request below. For Speaking and event requests, please see the Speaking Request Page here: Speaking Request Page.

Contact Information

First name*

Last name*

Email*

Phone number (make sure to include your country code)*

Title

Organization*

Please provide active social media links for your organization.*

Format Information

Please describe the intended focus/topic of your interview.*

Where will this interview take place?*

Phone

Skype

Zoom

Other

Interview Length (in minutes)*

Date range for interview to occur*

Your Audience Information

Where will this inverview be published/shared?*

Please describe your audience demographics.*

What is the approximate size of your current distribution (readers, viewers, listeners or subscribers) of your audience?*

Any other relevant comments, questions, or information?