Days with Dyslexia Podcast application

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
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3
Website or professional profile (optional)If this does not apply to you, simply skip the question.
4
Which best describes you?* This field is required.Select all that apply.
Parent/ caregiver
Educator
Speech-language Pathologist
Reading/literacy professional
Researcher/ academic
Author
Person with dyslexia or other learning difference
Other
5
Tell me a little about yourself and your connection to dyslexia, literacy, learning, or supporting children and families.* This field is required.
6
If you are applying based on professional expertise, what education, training, credentials, or experience do you have in this area?If you’re applying to share a personal or parent perspective, you can simply write “N/A.”
7
What would you like to talk about on the podcast?* This field is required.Please briefly describe the topic or story you would like to share.
8
What are 2–3 things you would want listeners to learn, understand, or take away from our conversation?* This field is required.
9
Why do you think this topic would be valuable to parents, educators, or professionals supporting children with dyslexia and literacy difficulties?* This field is required.
10
Is there something about your perspective, experience, or approach that you think would add something different to this conversation?(Optional)
11
Are you hoping to promote a product, service, book, program, course, or other offering during the interview?* This field is required.
No
Yes
Possibly
12
Please briefly tell me what you would like to promote and how it relates to the proposed conversation.
Huge
Large
Normal
Small
Ok
Ok
13
How did you find the podcast?* This field is required.
I listen to the podcast
Social Media
Website/ Search
Someone recommended it to me
I was referred by a previous guest
Podcast booking/ guest service
Other
14
Have you listened to the podcast before?
Yes, regularly
Yes, I've listened to a few episodes
I've listened to one episode
Not yet
15
Are you submitting this application for yourself or on behalf of someone else?* This field is required.
Myself
I am a publicist, agent, or representative submitting on someone's behalf
Other
16
Who are you recommending, and why do you believe they would be a strong fit for this podcast?
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What happens next?* This field is required.Thank you for your interest in being a guest! I review submissions based on topic, expertise or experience, and fit for the podcast audience. Submitting this form does not guarantee an interview. If your topic seems like a good fit, I'll reach out with next steps and additional information.
Great, thanks!
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