"Greetings! If you would like to receive product, press releases and more from BSG PR, please fill out the information below. We will review and respond as soon as possible."
1.   Name
First Name

 Last Name


Title

2. Skip this section if you are strictly freelancing.
Company Name

University Name (If affiliated with one)

Type of Media (Newspaper, Magazine, TV Program, Website, Radio Syndicate, etc)

How frequently do you publish or air(daily,weekly,monthly,annually, etc)

How would you describe the primary editorial focus of your outlet (Rock, Country, General News, Entertainment News, Men, Women, Teens, Farm Machinery, etc)

3. Where are you located?
What is the major metropolitan area nearest to where you live?

What is your Primary Mailing Address?

Please provide us with your address. Only one is required, but as many as you'd like to give us would be appreciated. If you only give us one address, please be sure it is the same one you just identified as your Primary Mailing Address. Also, if your primary mailing address is a P.O. Box, also give as a street address in case we need to use an overnight service that won't deliver to a P.O. Box.
Personal P.O. Box
(Home)		    Address 1
   Address 2
   City/State/Zipcode

Personal Street Address
(Home)		    Address 1
   Address 2
   City/State/Zipcode

Outlet P.O. Box
(Work)		    Address 1
   Address 2
   City/State/Zipcode

Outlet Street Address
(Work)		    Address 1
   Address 2
   City/State/Zipcode

4. Please give us information on how to phone and fax you.
Direct Work Phone: Extension:
Direct Work Fax:
Home Phone:
Home Fax:
Cell Phone:
Pager:

5.
What is your e-mail address?
Work E-mail:
Personal E-mail:
Which e-mail of the two above is the best place to e-mail you?: Work
Personal

6.
Is there a way we can look at your work online?
Work URL:
Personal URL:

7.
Freelance information
List the outlets you freelance for (up to 10)

8.
If any of the following descriptives apply to you, please check it.
Artist Manager
Booking Agent
Concert Promoter
DreamWorks Employee
Film Music Supervisor
Photo Editor/Art Director
Photographer/Clothing Stylist/Hair Stylist/Make-up Artist
Style Editor
Television Music Supervisor
Television Talent Booker
U.S. Correspondent For A Foreign Publication
Universal Employee
Freelance

9.
Do you want:
Breaking News
Release Schedules
Tour Information

10.
Do you review:
Home Videos
Music Videos
DVD

11.
My articles/reviews are syndicated through a wire service (print journalists only):
Syndicated (If checked please give us the name of and/or information about your wire service in the notes section below)

12.
Which of the following music genres are you interested in? (Please check all that apply)
Alternative/Indie/Punk
Broadway
Christian
Comedy/Spoken Word
Country
Electronica
Folk/Blues
Hard Rock
Hip-Hop
Jazz
 Latin
Movie Score
Movie Soundtrack
Pop
R&B
Rap
Reissues
Rock
Teen
World

13.
Memo notes
Is there anything else we should know about you? For instance, when is the best time to call you? What time or day is your deadline? How long is your lead time to receive materials in order to write about them? Any information on how you would like us to work with you to make your job easier would be appreciated.

14.
What's your Birthday? (This is optional, but at least a month and date would be appreciated)

mm/dd/yyyy //




BSG PR 20501 Ventura Blvd, Suite 145, Woodland Hills, CA 91364 | p.818-340-4422 | f.818-340-0040