• CTR MEDIA NETWORK TV SHOW - GUEST INTAKE FORM

  • Help us prepare an exceptional episode together. Complete each section so we can set you up for maximum impact— before, during, and after your feature.
  • SECTION 1 — YOUR BASIC INFORMATION

  • Format: (000) 000-0000.
  • SECTION 2 — YOUR STORY & EXPERTISE

  • Primary Topic Area (Select one)
  • SECTION 3 — Preparing for your Interview Apperance

    To help us guide the conversation in a way that best amplifies your voice, supports our audience, and provides extended value to you during your interview, we offer two options. You can choose whichever is easiest for you.
  • Option 1:

  • Do you have up to 10 questions you would like us to consider asking during your interview? If so, please list them below. While we cannot guarantee that all of these questions will be asked, your suggestions help guide the conversation and ensure we highlight the topics that best amplify your voice and message on our platform.
     
     
     

  • Option 2:

  • If you’re unsure what questions to suggest, you can simply answer the guided questions below to help shape the direction of your interview. Your responses will help us craft thoughtful questions and create a conversation that brings value to both you and our audience.
     
     
     
     
     

  • SECTION 4 — YOUR CALL TO ACTION

  • At the end of your episode, we give you a moment to direct our audience. Make it count — one clear, compelling action you want them to take.
  • Are You Offering a Free Gift to Our Audience?
  • SECTION 5 — FINAL DETAILS

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  • SECTION 6 — INVESTMENT ACKNOWLEDGMENT

  • CTR Media Network TV operates as a full multimedia platform — combining television, podcast, magazine, blog, and social media distribution. Delivering your feature at this level requires a dedicated production, marketing, and distribution team working on your behalf. $150

  • Your guest feature investment covers:
    • Your Interview Experience Includes:

    • Full CTR Media Network Interview — A professionally produced video and audio interview designed to highlight your story, business, brand, book, organization, or expertise.

    • Professional Production — Video and audio production to ensure your interview is broadcast-ready for distribution across our media platforms.

    • Multi-Platform Distribution — Your interview is distributed through the CTR Media Network media ecosystem, including television, podcast, radio, and social media, with streaming availability across platforms such as Roku, Amazon Fire TV, Android TV, iOS, YouTube, the CTR Media Network App, Web App, and major podcast platforms.

    • Global Visibility — CTR Media Network's digital distribution ecosystem extends into 175+ countries and all 50 U.S. states, helping your message reach audiences beyond your immediate network.

    • Marketing & Promotion — Your feature is promoted throughout our digital ecosystem, which may include our social media platforms, blog, email audience, and other CTR Media Network promotional channels.

    • CTR Media Network Digital Magazine Cover Feature — You will receive a digital magazine cover feature, providing you with an additional professional media asset that can be shared with your audience.

    • Social Media Video Clips — Selected short-form video clips will be created from your interview, giving you additional content that can be shared across social media.

    • Professional Promotional Graphic — You will receive a branded promotional graphic to help you announce and market your CTR Media Network appearance.

    • Your Interview Copy — You will receive a digital copy of your completed interview to use across your own website, social media, media kit, speaking portfolio, and marketing platforms.

    • Continued Exposure — Your episode may continue to replay throughout the remainder of the year, helping extend the life and visibility of your interview beyond its initial release.


      More Than an Interview
      Our goal is not simply to interview you for one day.

      We want to take one powerful conversation and transform it into multiple pieces of media that can continue introducing you and your work to new audiences.

      Your interview becomes a piece of digital real estate that you can continue using to build authority, strengthen your media presence, and create new opportunities.

      $150 Giveback Initiative
      As part of our Giveback Initiative, selected guests have the opportunity to receive this interview experience for $150 instead of $300.

       

  • Investment amounts are confirmed separately by the CTR Media Network TV team prior to scheduling and must be paid before the interview. Submitting this form does not guarantee a booking. All featured guest spots are subject to availability and approval.

  • SECTION 7 — MEDIA RELEASE & CONSENT AGREEMENT

  • Please read the following carefully before signing. Submission of this form constitutes your agreement to the terms below.
  • Media Release

  • By completing and submitting this guest intake form, I ("Guest") hereby grant CTR Media Network TV, CTR Media Network, and its host, Tina Ramsay, and all associated brands, platforms, and affiliates ("CTR Media Network TV") the irrevocable, royalty-free, worldwide right and license to record, produce, edit, reproduce, repurpose this video, reair episode, publish, distribute, broadcast, stream, and promote my name, likeness, voice, image, biographical information, and the content of my interview appearance in any and all media formats now known or hereafter developed in media and distrubution.

  • This includes but is not limited to:

    • Television streaming platforms (Amazon Fire TV, Roku, Android TV, iOS, and others)
    • Podcast and audio distribution platforms
    • YouTube and video platforms
    • The CTRMN App
    • Digital magazine and blog
    • Social media platforms
    • Email marketing and newsletters
    • Promotional and marketing materials
  • No Compensation

  • I understand and agree that I will not receive any monetary compensation, royalties, residuals, or remuneration of any kind — now or in the future — for my appearance, interview, or any content produced as a result of my participation on CTR Media Network TV. This applies to all uses of my interview across all platforms and media formats, regardless of the number of times the content is aired, streamed, shared, republished, or repurposed.
  • Content Accuracy

  • I confirm that all information, statements, and claims I make during my interview are true and accurate to the best of my knowledge. I agree to hold CTR Media Network TV harmless from any liability arising from the content of my interview.
  • Right to Edit

  • I understand that CTR Media Network TV reserves the right to edit, condense, or adapt my interview for clarity, length, platform requirements, or production purposes, provided that such edits do not materially misrepresent my words or intent.
  • Promotional Use

  • I grant CTR Media Network TV permission to use my name, photo, headshot, logo, bio, and social media handles for promotional purposes in connection with my episode feature, including but not limited to social media posts, press releases, website listings, email announcements, and magazine features.
  • Guest Copy

  • I understand that I will receive a copy of my interview for my own personal marketing and promotional use. I may share, repost, and repurpose my interview copy across my own platforms. I may not sell or license the content to third parties without written permission from CTR Media Network TV.
  • CONFIRMATION & SIGNATURE
  • No Refund Policy

    All guest feature investments made to CTR Media Network TV are final and non-refundable. By submitting this form and confirming your investment, you acknowledge and agree that no refunds, credits, or transfers will be issued under any circumstances, including but not limited to cancellation, rescheduling, or failure to appear for your scheduled recording. CTR Media Network TV invests in production, marketing, and distribution resources on your behalf upon confirmation of your feature, and as such, all payments are considered earned upon receipt.

    If you need to reschedule your recording date, please contact our team at least 48 hours in advance. Rescheduling is subject to availability and does not constitute grounds for a refund.

  • Are you willing to share this interview with your own audience?
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • By submitting this form, you acknowledge that you have read and agreed to all terms above. CTR Media Network TV will contact you within 3-5 business days with your next steps.

    Our Business Hours are:

    Monday-Tuesday
    9 AM–5:00 PM

    Wednesday CLOSED

    Thursday-Friday
    9 AM–5:00 PM

    Saturday-Sunday CLOSED

  • Questions? Visit ctrmedianetwork.com CTR Media Network TV - Creating Impact Since 2018
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      CTR Media Network TV Show

      Media Placement & Distribution


      No Refund

      $149.00$149.00
        
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