Podcast Video Interview Request Form
Contact Information
Full Name
*
First Name
Last Name
Pen name/ Pseudonym
Contact Number
Please enter a valid phone number.
Email Address
*
example@example.com
Professional Information
Job Title(s) (e.g. Writer, Actor, Director, Artist, etc.)
*
Short Bio (your background, expertise, interests, achievements, etc.)
*
A jpeg/png picture of yourself (this will be used for the thumbnail of the podcast episode!)
*
Browse Files
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Projects Information
Project Description 1
*
Project URL 1
*
Project Description 2
Project URL 2
Project Description 3
Project URL 3
Social Media Information
Instagram URL
X URL
TikTok URL
LinkedIn URL
Facebook URL
YouTube URL
IMDB Profile URL
Other Social Media URL(s)
Please make sure you have the following available for the interview:
*
A computer with a functioning camera and microphone
A quiet environment with no distractions to conduct the interview in
Good attitude and willingness to share your story with the world!
Additional Comments
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