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SPEAKERS AND EXPERTS GUIDE


SPEAKERS AND EXPERTS GUIDE INFORMATION FORM


Name:

Title:

Department:

Office phone:

Home phone:

Cell phone:

E-mail:


May we provide your home phone number to the media upon request?
Yes No

Are you willing to do interviews?

Television Radio Print

Areas of expertise on which you are available for news/media interviews:


Recent publications, research or projects:


Are you willing to do public speaking to local audiences?

Yes No

If so, who is the presentation suitable for:

Professional/Business Groups Community Organizations
Schools
Age Group

Speech titles

Are you willing to give interviews in another language and if so which one(s)?


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