Podcast Guest Form
The Rewrite the Mother Code podcast focuses on challenging the traditional notions of being a mother. The show empowers people who identify as women to love themselves holistically by rewriting their mother code and enables listeners to begin to embody the woman they truly are.
Name
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First Name
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Please write the phonetic pronunciation of your full name
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Organization
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example@example.com
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Bio
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What inspired you to be on Rewrite The Mother Code?
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What are three questions might you like Gertrude to ask you on the podcast?
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Conversation Topics Can Include:
◇Where do you see unhelpful mother codes in our culture today? ◇What were your mother codes when you first became a mother? ◇What codes were from your family, your culture? ◇What are your mother codes now? ◇What does it mean to rewrite the mother code? ◇What is your vision for yourself as a mother and how has it evolved? ◇What are some practices that have helped you rewrite your mother codes? ◇How have you mothered yourself today or this week?
Please share any links to past speaking engagements
Do you host a podcast? If so, provide a link to it below.
If Yes, would you like Gertrude to be a guest?
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No
Please provide headshot(s) to utilize in the podcast promotional materials.
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How did you hear about us?
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I'm a listener
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Who referred you to us?
Please share their name or podcast name.
We will be recording both video and audio and posting to YouTube. Are you okay with that?
Yes, consider me camera ready!
No, I'd rather not be posted to YouTube.
Maybe. Ask me when we record.
IMPORTANT! If you haven't listened and reviewed the podcast, please do so here: https://podcasts.apple.com/us/podcast/rewrite-the-mother-code-with-dr-gertrude-lyons/id1647908663. This will help expand our audience reach for your podcast episode! ⭐⭐⭐⭐⭐
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Done
I will and understand this is a condition of my episode going live.
I understand that this will be a video podcast and will come prepared.
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Yes
No
I agree and understand that I will be tagged as a collaborator on Instagram reels and posts to reach a wider audience to share my gifts and expertise with. I will accept the invitation to be a collaborator and agree to share a minimum of 3 pieces of content with my audience (including but not limited to social media posts, podcast link, YouTube link, blog post, etc.) If not, I understand that I will forfeit any further marketing of my episode.
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Yes, I agree!
No
Guest Release: By participating in "Rewrite the Mother Code" interview, you agree to allow the host, Dr. Gertrude Lyons, to record, distribute, disseminate the podcast in any manner. You also agree to allow Dr. Gertrude Lyons to retain rights to the provided and produced media for potential future use in speeches, books, and all other public distribution, including video.
I agree!
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