The 2000-2002 Media Resource Guide will come out this academic year. It will be available to local, regional and national media, as well as community organizations.  If you are interested in being available for media interviews or public speaking, please fill out the following information.

Name________________________________________
Academic Title   _______________________________ 
Department   _________________________________
Office telephone   _____________________________ 
Home telephone_______________________________(optional, but helpful due to the round-the-clock nature of breaking news and media deadlines)
Email Address   _______________________________ 

Please designate below your availability for the following speaking activities:

Expertise Areas/Lecture Topics
(please be specific and concise)

                                                                          MI                       PS 
1. _______________________ 
2.________________________                                                              ¨  3.________________________ 
4. ________________________ 
 

Qualifications– Feel free to include membership in professional organizations, years of experience, etc.  Please do not send full vita.
 

                                                                                                                                                                                 Your signature is requested for verification purposes.

Signature___________________________________________

Please return by Wednesday, November 1, 2000 to: Misti Goodson, Office of University Relations, 340 Administration Bldg. or e-mail the information to mgoodson@nsu.edu

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