Public Relations Questionnaire


NAME:	E-MAIL:

TELEPHONE:	COMPANY:


DO YOU HAVE A 300 DPI JPEG HEAD SHOT PHOTO?	DO YOU HAVE BOTH A CURRENT SHORT AND LONG BIO?
YES NO	YES NO

PAST PUBLIC RELATIONS ACTIVITIES:


AWARDS RECEIVED:


INTERVIEWS GIVEN (LIST MEDIA AND DATES):


DO YOU ENJOY PUBLIC SPEAKING?
YES NO

POSSIBLE SPEAKING TOPICS:


DO YOU OR DOES YOUR FIRM PRODUCE A NEWSLETTER?
YES NO

IF YES, HOW OFTEN?


DO YOU ENJOY WRITING ARTICLES?
YES NO

POSSIBLE ARTICLE TOPICS:


DO YOU ENJOY HOSTING SOCIAL EVENTS?
YES NO

IF YES, WHAT TYPE?


DOES YOUR SPOUSE OR SIGNIFICANT OTHER ENJOY HOSTING SOCIAL EVENTS?
YES NO

SUBMIT THIS FORM TO (Choose One Person) :