Autism In Color: Guest Inquiry
Thank you for your interest in being a guest on Autism In Color with your hosts La Becky & Chavon. Please answer the following questions and statements. Once you hit submit, you will be given the opportunity to schedule your video call/in-person meeting with La Becky & Chavon.
Name
*
First Name
Last Name
Business Name
Type of Business/Product (if applicable)
Primary Contact Number
*
Please enter a valid phone number.
Alternate Contact Number
E-mail
*
example@example.com
How did you hear about Autism In Color?
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In a few words, tell us why you would like to be a guest on Autism In Color. Please include a story of how Autism impacts your life, and information you would like to share on the show. If your interest is not specifically related to Autism, tell us about what information you would like to share with our audience.
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How can we find you on social media. If none of these apply to you, feel free to leave that section blank. Social media is not required.
Facebook
Twitter
Instagram
YouTube
Your Website
I understand that this is a preliminary conversation with La Becky & Chavon for Autism In Color and does not guarantee me a spot on the show.
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Yes
I understand that there is a financial investment to appear on the radio show (This applies to guests who are promoting their business, service, product, etc.)
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Yes
Not Applicable.
I understand that this interview is being recorded both in audio and video formats and I agree to have Let's Talk About It...The Autism Center, Inc. and its subsidiaries (Autism Vibes Radio/Autism In Color) use the footage on their various broadcast and social media formats.
*
Yes
No/I am no longer interested in doing an interview with Autism Vibes Radio.
I am interested in promoting my business/product/service on your show. Promotional interview fees start at $75 for 1/5 hour.
Yes. Please contact me about format, pricing, and payment.
No. I am only interested in sharing my story/expertise with the AVR audience.
Maybe. I'd like to hear more about this opportunity.
I affirm that I fully understand all questions that were asked on this form.
I affirm that all responses that I provided on this form are true and were made of my own volition.
Please upload a headshot. This photograph will be used on our various social media outlets to promote your interview.
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Please upload a bio or other important information you would like to share during the interview.
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