Media Request Form

Media Request Form

All media inquiries must be made in writing. Please allow at least three business days for initial response.

The survey will take approximately 5 minutes to complete.

1. Full Name*

2. Contact Email*

Select or enter value

3. Contact Phone Number*

Phone

4. Media Outlet*

5. Role / Title*

6. Interview Deadline*

Date by when you will need to complete the interview.

7. Expected Date of Publication*

8. Background Details on the Article*

Please provide details on story, what other departments are participating, who you hope to speak with in Financial Services, etc.

9. Interview Format and Allotted Time Needed*

For example, can be conducted by phone, in person, zoom, or via written response. Need 10 - 15 minutes for questions etc.

10. List of Sample Questions*

List of specific questions you would like answered.

Please note we do not guarantee follow up to any media inquiries without a list of sample questions.

Send me a copy of my responses