Faculty Expert Submission Form

Name

 

Title/Position

 

School or Department

 

Office Phone

 

Email

 

Please indicate if you would like to list your home number on the Faculty Experts site:

 

 

Yes

 Yes

No

 No

Home Phone #

 

Please indicate if you would like to list your cell number on the Faculty Experts site:

 

 

Yes

 Yes

No

 No

Cell Phone #

 

Faculty Member Website

 

Areas of Expertise

 

*maximum of five areas, short phrases in lay terms

Are there any topic areas or issues on which you would prefer not to be interviewed?

 

 

Yes

 Yes

No

 No

If yes, please describe those areas:

 

Other professional affiliations/research chairs:

 

Other languages spoken:

 

Photos for website

 

 

Yes

 Yes

No

 No

If yes, attach your photo

 

Media Experience

 

 

None

 None

Very little

 Very little

A lot

 A lot

Print Media

 

 

Yes

 Yes

No

 No

Broadcast

 

 

Yes

 Yes

No

 No

Have you had media training?

*

 

Yes

 Yes

No

 No

*media training helps you concisely phrase your main points to the media

Would you like media training?

*

 

Yes

 Yes

No

 No

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