Real World Media Training Enrollment Form Real World Media Training Enrollment Form 2 Workshop Date Name * Title * Company * Street Address * Address Continued City * State * Zip * Years With Company * Email Address * Job Responsibility Educational Background/Job Experience Do You Serve as a Spokesperson? Yes No Do You Prepare/Coach Spokespersons? Yes No Past Experience with News Media (Prior interviews with TV/Newspapers/Bloggers - good, bad, indifferent): Past Media Training, if any. Kind of course/ When: Your major concerns about being a spokesperson: Your worst media nightmare as it would apply to you and your organization: What do you hope to get out of this course? If you are human, leave this field blank.