Microsoft PressPass - Online Executive Request Form

Please provide the following information in order for us to process your request. Items marked with an (*) are required.

The information you provide will be used solely to process your specific request. It will not be shared with anyone outside of the company or used for marketing purposes. For more information about Microsoft’s privacy policies, please visit http://www.microsoft.com/privacy.

Type of request

Select an executive:
If your first choice of Executive is not available, do you have an alternate Executive in mind?
Alternate choice #1:
Alternate choice #2:

Event Details
*Event Name:
*Event Date:(mm/dd/yyyy)
*Event Time: (hh:mm ex: 09:30)
Event Location
*Venue:
*City:
*State:
Country:

Lead Contact (person in charge of event)
If the contact information is the same as above check here. (if this box is checked, then "required" fields below are not "required)
*First Name:
*Last Name:
Title:
Company:
Address:
Address 2:
City:
State/Province:
Country:
Zip/Postal Code:
Phone: (Ex: 111-555-1234)
*Email: (Ex: abc@de.com)
Fax:

Speech Details

Type of Presentation:
*Keynote Topic:
Expected Attendance Number:
Audience Profile: Maximum characters 75
*Confirmed Speakers: Maximum characters 200
Invited Speakers: Maximum characters 200
*Press and/or Analysts Attending:
Event Theme & General Details: Maximum characters 800
Event Agenda: (copy/paste - optional) Maximum characters 500

Online Executive Request Form

Contact: (person making request)

*First Name:

*Last Name:

Title:

Company:

Address:

Address 2:

City:

State/Province:

Country:

Zip/Postal Code:

Phone: (Ex: 111-555-1234)

*Email: (Ex: abc@de.com)

Fax:

Have you submitted a previous request for this?

Type of request

Event Details

Event Location

Lead Contact (person in charge of event)

Speech Details