Guest Speaker Request Form
Thank you for your interest in being a guest on The Mother Effen Me podcast. This show is a safe space for real stories, healing conversations, and raw truth. Please complete this form honestly and fully. All submissions will be reviewed carefully.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number (optional)
Please enter a valid phone number.
Format: (000) 000-0000.
Instagram handle (If applicable)
Are you comfortable appearing on camera if this episode is recorded visually?
*
Yes
No
Audio is only preferred
Available Topics
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March- Motherhood (Generational Cycles)
April- Trauma & Healing (Being Strong)
May- Confidence & Body (Your Body)
June- Friendship ( Friendship betrayal
July- Money & Hustle (Financial struggles)
August- Mental Health & Boundaries
September- Intimacy & Shame
October- Family & Boundaries
November- Gratitude & Grief
Episodes are recorded in Kenilworth NJ. Are you able to attend a live recording?
*
Yes
No
I would need to do virtually
Why do you feel called to share your story on The Mother Effen Me Podcast?
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Briefly describe your story or what you would like to speak about on the podcast. Please be detailed
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What season of your life are you currently in?
*
Is there anything about your story that you are NOT comfortable discussing publicly?
*
Best days to record:
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred time of day:
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Morning
Afternoon
Evening
Flexible
Are you comfortable with your episode being promoted across all platforms (Instagram, Spotify, Website, ETC)?
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Yes
No
Are you willing to promote your episode once it airs?
*
Yes
No
Have you ever been on a podcast before?
*
Yes
No
By submitting this form, you agree to the following:
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I understand that if selected, my episode will be recorded and distributed publicly
I grant
*
The Mother Effen Me Podcast permission to use my voice, image and story for podcast and promotional purposes
I understand
*
that submissions do not guarantee selection
Submit Request
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