Sikhona Media Inquiry Request

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Question 1 of 25

Full Name

Paragraph answer

Question 2 of 25

Role

A

Host

B

Producer

C

Journalist

D

Editor

E

Booking Contact

F

Other

Question 3 of 25

What's your Outlet / Show / Publication Name?

Paragraph answer

Question 4 of 25

What's your Organization / Network / Company Name?

Paragraph answer

Question 5 of 25

Email Address

Paragraph answer

Question 6 of 25

Phone Number

Paragraph answer

Question 7 of 25

What's your Website or Show Page URL(s)?

Paragraph answer

Question 8 of 25

What's your Social Media or Channel Links?

Paragraph answer

Question 9 of 25

Inquiry Type

A

Podcast

B

Interview

C

Live In-Person

D

Editorial / Written Feature

E

Press Feature

F

Other

Question 10 of 25

Media Format

(Select all that apply)

A

Audio

B

Video

C

Written

D

Other

Question 11 of 25

Live or Pre-Recorded

A

Live

B

Pre-Recorded

C

Not Sure Yet

Question 12 of 25

Recording / Interview Platform (ex. Zoom)

Paragraph answer

Question 13 of 25

Estimated Length | media (audio/video) or word count (editorial)

Paragraph answer

Question 14 of 25

Proposed Topic(s) or Angle

Paragraph answer

Question 15 of 25

Why are you requesting Dr. Michael Thompson specifically?

Paragraph answer

Question 16 of 25

Will questions and agenda be provided in advance?

A

Yes

B

No

C

Other

Question 17 of 25

Are there any sensitive or restricted topics Dr. Michael Thompson should be aware of?

Paragraph answer

Question 18 of 25

Requested Recording / Interview Date(s)

Paragraph answer

Question 19 of 25

Deadline (if editorial)
(If there is no deadline enter N/A below)

Paragraph answer

Question 20 of 25

Time Zone

A

Eastern Time

B

Central

C

Mountain

D

Pacific

E

Other

Question 21 of 25

Where will this content be published or distributed?

Paragraph answer

Question 22 of 25

Is this a paid opportunity?

A

Yes

B

No

Question 23 of 25

If yes, please specify fee or compensation
(If no, enter N/A below)

Paragraph answer

Question 24 of 25

Content usage right / syndication details

Paragraph answer

Question 25 of 25

Add any additional notes or context

Paragraph answer

Confirm and Submit

Name

Email

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Sikhona Media Inquiry Request

Click the button below to start.

Full Name

Role

What's your Outlet / Show / Publication Name?

What's your Organization / Network / Company Name?

Email Address

Phone Number

What's your Website or Show Page URL(s)?

What's your Social Media or Channel Links?

Inquiry Type

Media Format

Live or Pre-Recorded

Recording / Interview Platform (ex. Zoom)

Estimated Length | media (audio/video) or word count (editorial)

Proposed Topic(s) or Angle

Why are you requesting Dr. Michael Thompson specifically?

Will questions and agenda be provided in advance?

Are there any sensitive or restricted topics Dr. Michael Thompson should be aware of?

Requested Recording / Interview Date(s)

Deadline (if editorial)(If there is no deadline enter N/A below)

Time Zone

Where will this content be published or distributed?

Is this a paid opportunity?

If yes, please specify fee or compensation(If no, enter N/A below)

Content usage right / syndication details

Add any additional notes or context

Confirm and Submit

Deadline (if editorial)
(If there is no deadline enter N/A below)

If yes, please specify fee or compensation
(If no, enter N/A below)