Podcast Interview Form
Name
*
First Name
Last Name
Phone
*
Email
*
example@example.com
Please upload your headshot, which may be used for the promotion of your episode. (500 X 500 PX)
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Website Link:
Social Media Links:
Please provide your bio below (150 words max.)
*
Why would you like to be on The Client Connection and what topics would you like to discuss?
*
Where is the number one place you'd like me to direct the listeners? (ie. Website/Instagram/Facebook)
*
I will have a microphone for this interview.
*
Yes
No
I will have a quiet environment to record the interview.
*
Yes
No
How did you hear about us?
*
I agree to the release and promotion of this interview on The Client Connection.
*
Yes
No
Submit
Should be Empty: