CONTRIBUTOR DATA CAPTURE FORM
Hello! This form helps us capture all your key data so that we can correctly tag, promote, share and publish your video. It also helps give us some steer on the best topics to add into our discussion.
Name
*
First Name
Last Name
Email
*
example@example.com
whatsapp number (include country code)
*
Please select which type of contributor you are (select ONE)
*
Please Select
EPIC ENTREPRENEUR
INDUSTRY EXPERT
Please enter the URL for your linkedin profile (or personal website)
Please provide any information you think will be helpful (if there are new articles about you, your company website, videos you have online etc) or topics you like talking about / are an expert in. Leave blank if not.
Please proviode us with any socila profiles you have so we can tag these when we come to publish your video
TWITTER URL
YOUTUBE URL
FACEBOOK URL
INSTAGRAM URL
Is there an event or date that you would like us to publish your video on (e.g. if you have a new product launch, other press activity happening etc) / leave blank if not.
-
Month
-
Day
Year
Date
Please verify that you are human
*
Submit
Should be Empty: