Podcast, UAMA, Zero Fuxx & Panel Show Guest Form
Name
*
First Name
Last Name
Please write the phonetic pronunciation of your full name
If required
Organization
If relevant
What would you like to take part in?
Podcast (Conversational/Discussion/Informal Interview)
Ultimate AMA (Interview)
Panel Talk Show (YouTube and IGTV)
Zero Fuxx (Rant video)
Chosen Topic(s)
*
Why do you want to take part?
*
Phone Number
*
E-mail
*
example@example.com
Personal Website
Bio
Anything to promo?
Please detail what you'd like to promo on the show (If relevant)
Social Media Channels, Website Links, etc.
Please share any links to past speaking engagements, relevant content, etc.
Please provide a high-resolution headshot to utilize in promotional materials
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Anything you want to add?
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