Podcast Form

Podcast Guest Form

Guest First name *

Guest Last name *

Email *

Phone number *

Please write the phonetic pronunciation of your full name *

Preferred Company Name to Promote *

Summarize your business and business model in two sentences. *

Is there any part of your business model that’s controversial, please explain. *

What is the most surprising, an unexpected part about your business the most people would not understand. Please explain in two sentences or less. *

Website *

Facebook

Instagram

Other

What city and state will you be flying from? *

Are you bringing a partner with you to appear on the show? *

If so, what's your partner's name?

Partner Email

Three impressive stats to brag about you for our title purposes *

Topics you want to discuss *

Anything you do NOT want to cover on the podcast

Top 5 turning points in your career & life *

What is your top 3 skills that your are the best at over all others? *

What are you most proud of that you have done professionally? *

Please provide 2-3 high-resolution headshots/full body photos to utilize in the podcast promotional materials *

Please upload a high-quality image (PNG, JPG preferred) of your company's logo you wish to promote on the show *

Please attach your bio *

Anything you want to add?

Full Mailing Address

What is your shirt size? *

Podcast Guest Release and Consent
‍By submitting this form and appearing on the podcast, you (“Guest”) agree to the following:

‍Ownership: All content recorded during the podcast (audio, video, written, or otherwise) is the sole property of the podcast and its host (“Podcast Owner”).
‍Usage Rights: Guest grants the Podcast Owner full rights to use, publish, edit, and distribute the content in any format and for any purpose, including marketing, sales, promotion, and monetization.
‍Release of Claims: Guest waives all claims against the Podcast Owner, host, affiliates, and agents relating to use of the content, including for defamation, privacy, or publicity.
‍Sensitive Topics: Guest must identify any off-limits topics in writing prior to recording. Otherwise, all topics may be discussed and included.
‍No Compensation: Guest understands that participation is voluntary and no payment or royalties will be provided now or in the future.By submitting this form, Guest agrees to these terms and authorizes the Podcast Owner to use the content freely.

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