JOHN BRADSHAW
Confidential Media Interview Request Form
If you are a member of the media, need a source or a story and are interested in interviewing John Bradshaw for your program or article, please complete the attached Confidential Media Interview Request Form, or you may contact John Bradshaw Media Group by phone at (713) 771-1300, by fax at (713) 771-1362, or by e-mail at .
To better respond to your request we would be grateful if you would take the time to provide detailed answers to the questions below. This information is solely for in-house use and will not be passed on to any other organization.
Due to John Bradshaw’s extensive travel, speaking and writing schedule, all requests for interviews are appreciated and will be considered based upon his availability. Please include with your request, the name of the media entity you represent, the deadline for your story, the topic, the circulation, or reach, and the demographics of your audience. All requests will be considered as soon as possible.
All fields required—please complete as much as possible.
Thank you.
John Bradshaw Media Group
JOHN BRADSHAW
Confidential Media Interview Request Form
First Name:Last Name:
Title:
Company Mailing Address:
E-mail Address:
Phone Number:
Fax Number:
Is this interview in conjunction with a speaking engagement?
Yes No
Kind of Media Outlet (Publication Name, News/Radio Station, Podcast, Other Organization):
Program Name, Show, Section, or Title:
Circulation Reach:
Audience Demographics:
When & where are you distributed/broadcast?
Anticipated Release Date:
Website Address:
Location of Interview:
Length of Interview:
Topic(s) or story you are interested in (If you need help with a topic, Mr. Bradshaw will suggest one):
Will a photographer or film crew be present?
Yes No
Size of Crew (if applicable):
Contact Name:
Contact Phone Number:
Preferred time and method to be contacted:
P.O. Box 667147 ● Houston, Texas 77266-7147
(800) 6BRADSHAW or (800) 627-2374 ● US and International: (713) 771-1300 ● Fax: (713) 771-1362
Webpage: johnbradshaw.com ● Email:
Orders & Customer Service:
To Schedule an Event: