First Name *

Last Name *

Company Name *

Phone *

Email *

Address

Street Address

City

State

Country

Postal Code

Website *

Facebook Business Page

Facebook Personal Page

Instagram

Substack

Social Media Presence *

Approximately how many followers do you have across all your social platforms?

Cross Promotion *

Cross-promotion is key and essential to a successful show. Are you willing to promote your show?

Assistants Name

Assistants eMail

Assistants Phone Number

Why are you interested in being a Guest on The Gloria Show? *

The Gloria Show features thought leaders, coaches, experts, and individuals with lived experiences who can contribute to meaningful conversations around personal development and growth. When providing your topics, please ask yourself:

“Will this help someone reflect, grow, or take a meaningful next step?"

Below, you have the opportunity to provide up to 3 main topics that you typically speak on that align with the show's core mission and a brief synopsis of each topic. You don't need to provide three; one is required. When providing your synopsis, please include the following:

Why is this topic important right now?
What are 3 key takeaways the audience will gain from this conversation?
Who is this conversation for, and what are they currently struggling with?
What is one practical tool, framework, or strategy you will share?

Topic One *

Topic Two

Topic Three

The Gloria Show airs LIVE every other Tuesday at 2:00 PM EST. Are you available at this time to be a guest on the show?

Please provide your Bio. (Max of 300 Words)

Headshot *

Click to upload

PNG, GIF, JPEG or JPG ( max 3 Files )Please upload a headshot we can use for promotional purposes.

How did you hear about the show? *

Referral Name

If you were referred, who referred you?

Is there anything you want to add?

Please feel free to share anything else you'd like us to consider as we review your application.

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications, among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt out.

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