Multifaceted AF Podcast Intake Form

The Multifaceted Mama brand was created as a celebration of the ability to show up authentically in the spaces and places that we operate in each day and to inspire others to be their unapologetic, goal-getting, don’t-put-me-in-a-box selves while celebrating their ability to show up authentically in the spaces and places that they operate in each day.

The Multifaceted AF podcast is an opportunity to share these stories.

THANK YOU for your willingness to participate and for taking some time to answer the questions below so we can capture a glimpse into your story.

Full Name

Email *

Phone *

Finish this sentence: “I am Multifaceted, I am so much more than just…” and explain. *

In the spirit of being "Multifaceted", how else would you describe yourself? (ex. family relations, skills, talents, hobbies, etc.) *

Which representation category do you identify with? *

What does representation mean to you? *

Did you have any representation examples that you looked up to? How did the presence or absence of that representation effect you? *

We believe that seeing people that look like us doing the things we aspire to do is invaluable. In what ways have you "represented" as an example of a black person in your industry/field? *

Do you have a bio you can share? Please copy and paste below *

Please share a headshot that you would like us to use for promotion of your episode. Do you have any photos or videos you would like to share that showcase your story in action or to help promote your passions? Please upload here *

Sharing your Story. The Multifaceted Brand is passionate about amplifying and bring these stories and conversations to light. Please share any businesses, products, events, initiatives you are interested in discussing/promoting. *

Are there any topics you would like to avoid during your conversation? *

Please provide your social media handle if you would like to be TAGGED in the sharing of your story. *

Please provide the URL (link) for any products, service, event, initiative, etc. you would like us to share/ include in your show notes. *

What size t-shirt do you wear?

Photo/Video Release: I hereby grant permission to Multifaceted Enterprises, LLC (dba The Multifaceted Mama)(“Multifaceted”) to use my image on its website, related social media sites such as Facebook, Twitter, Instagram, etc., whether such sites are curated and designated as public or private. I also grant permission to Multifaceted to submit my image to other media outlets (online or hard copy) without further consideration. I understand that no names will be used on the website, social media, or other media unless I give specific, written permission.I understand that Multifaceted relies on the photo release form in the curation process before posting to its website and social media sites. I also understand that once any image is posted on its website, related social media sites or is submitted to other media outlets, the image can be downloaded. Please type "I agree" below.

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