Magnified Voices Podcast Guest Form
It's Time to Share Your Story
Name
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First Name
Last Name
Please write the phonetic pronunciation of your full name
Organization
Phone Number
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Format: (000) 000-0000.
E-mail
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example@example.com
Personal Website
Facebook
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Provide Your Bio in 100 words or less
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Why do you want to be featured on our podcast? Tell us your story.
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What are some other topics you want to discuss that are important to you?
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List up to 3 questions you would like to be asked.
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Please share links to any past podcast or speaking engagements.
Please provide a high-resolution headshot to utilize in the podcast promotional materials.
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How did you hear about us?
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Podcast Release
Guest hereby grants to the program its affiliates, agents, successors, and assigns the right and permission to record, use, publish, stream live, offer for sale, or otherwise distribute any audio or video interview or session with guest. Such right and permission includes, but it is not limited to the name of the guest, recorded audio or video, photograph or likeness, biographical information, handouts or any material based upon or derived. This grant of permission does not include the release of any of guest’s confidential information. For purposes of the paragraph, ''confidential information'' is defined as home address, email address, telephone numbers or date of birth of guest.
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