Full Name *

Company or Organization *

Who are you affiliated with?
What's your website? *

Where else can we find out more about you (i.e., Facebook, Twitter, Instagram, Pinterest, LinkedIn, etc.)?  Please provide full URLs. *

What is your current email list size? *

Which of the following BEST describes this appearance? *

Tell me more! *

Help me prepare by providing a brief description of your podcast, event, or opportunity:
  - How much time would I need to block out for the interview?
  - What's your ideal timeline (for recording and publishing)? 
  - For events: Where and when will it be held?
  - Who else is part of it?
  - What exactly would you like me to cover? 
Please be as concise and specific as possible.
Anything else I should know?

Thank you very much for your inquiry!  I know how valuable my audience is to me, and I'm honored you're interested in introducing me to yours.  I'll review your responses and will be in touch to discuss next steps if this appears to be a fit.

In the meantime, is there a particular response deadline I should keep in mind? *

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