Reporter Connection : Media Response Form

Media Response Form


To reply to this journalist, simply answer the questions below and hit Submit. Your reply will be emailed to them instantly (as well as to us so we can steadily improve our service and prevent abuse). We'll also email you a copy for your records. If interested, the journalist will then get in touch with you directly (not through our system).
 
Query # 19968
 
 
Query from:    
       
Deadline:    
       
Query Headline:  
       

Query:

   
       
 
 
Very Important - On-Target Replies Only:  Please ONLY reply to this media request if your answer is DIRECTLY related to the listing above. Since off-target replies waste journalists' precious time, anyone who submits anything not directly related to the above request risks being banned from Reporter Connection with future submissions blocked.
 
 
     
Question 1:  
     
Answer:    
       
 
 
     
Question 2:  
     
Answer:    
       
 
 
 
     
Last Question:   Anything else you'd like to add?
     
Answer:    
       
 
What would you like to be the subject line of your response to this reporter? You may leave it as-is with our default, but consider a better subject line which will stand out in their email.
 
Subject Line:    
 
Your Contact Information (Note: info you enter below is shared only with the reporter placing this query.)
 
*First Name:    
*Last Name:    
Job Title (if any):    
Company:    
*City:    
*State/ Province:    
*Country:    
*Phone1:   (e.g 123-456-7890)
Phone2:   (e.g. 123-456-7890)
*Email:    
Website:    
*Responder Type:    
     
Are you the person who'd be doing the actual interview with the reporter? If not please complete fields below.
Client/ Spokesperson Name:    
Company/ Organization:    
Client Website (if different):    
Client Phone Number1:    
Client Phone Number2:    
Client Email:    
   
  

To prevent automated entries, please ADD up the above numbers and enter the SUM in the yellow box:
(e.g. 1+1+1 would equal 3, enter 3)

 
 
 
 
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