Interview Josh - Josh.org

Name*

First Last

Email*

Phone*

Interview Contact

First Last

Organization Name

Organization Web Site

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Specific Event Date(s)

Type of Interview

Is this live or recorded?

If "recorded," what is the scheduled air date? (Enter in "Other" field)

Will this interview be taped?

Note: A master is requested by our ministry.

Audience Description

Include expected attendance.

Speaking Subject Requested

Or purpose of speaking engagement.

Are any new book publications tied to this interview?

What is the strategic purpose of this request?

What is your overall objective for this request?

Can Josh use his cell phone?

List any social media handles (e.g. hashtags):

We would like to promote the interview and your organization/station/ministry.

Please list any other pertinent event information.

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