The Golden Living Show Guest Application

The Golden Living Show Guest Application

Thank you for your interest in being a guest on The Golden Living Show. We're excited to hear your story and potentially share it with our audience. Please fill out the following application to help us get to know you better.
Personal Information
Name

First NameLast Name
Age
Address

CityState / Province
Email
example@example.com
Phone Number
Please enter a valid phone number.

Your Story
In 2-3 sentences, please summarize the story or experience you'd like to share on our show:
Why do you feel it's important to share this story now?
How has this experience shaped your perspective on aging?
What message or insight do you hope viewers will take away from your story?

Background Information
Please provide a brief biography (100-150 words):
Have you ever been interviewed on television or for a podcast before?

YesNo
If yes, please provide details:
Do you have any products or services that you'd like considered for "GG Approval"?

YesNo
If yes, please briefly describe them:

Additional Information
Are there any specific topics related to aging that you're particularly passionate about?
Is there anything else you'd like us to know about you or your story?
How did you hear about The Golden Living Show?

Availability and Preferences
Are you comfortable with an unfiltered, uncensored discussion of your experiences?

YesNoI'd like to discuss this further
What is your preferred method of recording?

In-person studio recordingRemote video recordingAudio-only recording
Please indicate your general availability for recording (days of the week, time of day):

Agreement

By submitting this application, I confirm that:
By submitting this application, I confirm that:
- The information provided is true and accurate to the best of my knowledge.
- I am willing to share my story openly and honestly on The Golden Living Show.
- I understand that if selected, I may be asked to provide additional information or participate in a pre-interview.
Date

MonthDayYear
Date
Signature

Powered by Jotform SignClear
Should be Empty:

Personal Information