2017 WAJ Media Guide Info Update

Media-Guide

 

 

 

Please use this form to update your Bio Information that will be used for the 2017 WAJ Media Guide. You may also submit a  new headshot.

 

 

* Required
*First Name:

*Last Name:

Title

Street Address:

City:

State:

ZIP Code:

Work Phone:

Home Phone:

Cell Phone

*Email:

Primary Media Outlet:

Additional Outlet

If you have a new headshot, attach it here. Acceptable file types are: JPEG, JPG, PNG, Max file size: 1MB