Media Inquiry

Name

Organization

Phone number

Address (optional)

Name of media outlet *

Type of media (e.g., newspaper, TV, radio, online publication)

Circulation/viewership/readership (if applicable)

Date of inquiry *

Deadline (if applicable)

Topic or story idea

Questions or specific information needed

Additional context or background information

Interview request (if needed)

Access to events or locations

Photo or video requirements

Permission for recording (if applicable)

Phone call

In-person meeting (if applicable)

Permission to use provided contact information for follow-up or additional inquiries

Permission to quote or attribute information provided in the inquiry

I consent to my submitted data being collected and stored by the Female Founders Institute for the purpose of responding to my inquiry.