Flipping the Lid Podcast Intake Form

First Name *

Last Name *

Phone *

Email *

City *

State *

Organization

Please list your social media handles *

Short Bio *

Please describe yourself in your own words (NOT your professional bio) *

Interesting Factors About Yourself *

What is your biggest problem in life or business? *

Is there anything you would like to promote on the show? *

Do you have access to a quality internet connection and web camera? *

Yes

Headshot *

Do we have your consent to send you show and company news and updates via email? *

Yes

We will create a kick-ass trailer for your episode but we need your help. Please send any promotional materials including additional photos, videos, interviews, or stage recordings our team can pull from. Send to [email protected] anytime prior to your interview.

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