| Name |
_____________________________________________
|
| Title |
_____________________________________________
|
| Organization: |
_____________________________________________
|
| Mailing
Address Line 1 |
_____________________________________________
|
| Mailing
Address Line 2 |
_____________________________________________
|
|
E-mail Address |
_____________________________________________
|
| Phone
Number |
_____________________________________________
|
| Fax
Number: |
_____________________________________________
|
| Primary
Job |
_____________________________________________
|
| Responsibility |
_____________________________________________
|
|
|
| 1. Have you
ever been interviewed by the news media? ________ |
|
2.
If yes, please identify some of your most recent interviews:
| Media
Outlet: |
_________________________________
|
| When: |
_________________________________
|
| Topic: |
_________________________________
|
|
|
3. Were the
resulting stories fair and accurate? Please explain.
|
|
|
4. How do
you feel about the interview process?
|
|
5. What is
your opinion of the news media?
|
|
6. What, specifically,
would you like to learn during your media training session?
|
|
7. Please
identify three or four key external audiences important
to your organization.
|
|
8. What is
your objective when participating in a news media interview?
|
|
9. Have you
participated in media training before? If yes, briefly
describe and provide approximate date.
|
