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Interview or Press/Media Feature Questionnaire
Please complete the questionnaire below to interview Michael or to feature him in the press or media.
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* Indicates required question
Name
*
Your answer
Email Address
*
Your answer
Telephone Number
*
Your answer
Organization
*
Your answer
What do you want to interview or feature Michael on?
*
Podcast interview
Press/media feature or interview
Social media live, e.g., LinkedIn Live, Facebook Live, etc.
Radio show interview
YouTube interview
Other:
Required
Purpose / intent of feature/press/media
*
Your answer
Date of interview/feature
*
MM
/
DD
/
YYYY
Location
*
In person
Online
Other:
Required
Audience size
*
Your answer
Age group of audience
*
Your answer
% women
*
Your answer
% men
*
Your answer
Topic request
*
Your answer
Interview length
*
Your answer
Do you have any special requests or any information you would like Michael to know?
*
Your answer
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