First Name *

Last Name *

Phone *

Email *

Birthday

Address

Mailing Address

City

State

Country

Postal code

Website

Facebook Link

Instagram Link

LinkedIn Link

Name of Your Podcast (if you have one)

Link to Your Podcast (if you have one)

Introduction Bio (I will use this to introduce you) *

Longer Bio for Show Notes

Links other than social, for Show Notes

Upload Your Headshot

How did you learn about the BOLD and Brilliant Podcast?

What was one BOLD Decision you made that changed your direction in life or business? (Share the basics here, we will elaborate on this question when we record your episode!)

Please include any relevant topics you’d like to be sure we discuss

Are there any topics you’d like to avoid or that are off-limits for you?

Do you have any media (previously recorded podcasts, interviews, blog posts, social posts) that I should read before the interview to get to know you and your expertise better?

As a podcast guest, you agree to the recording and distribution of your voice and performance as a part of the BOLD And Brilliant Podcast at no charge and agree not to request any compensation from Tracie Root.

Please initial below.

Initial 1

Clear

By agreeing to be on BOLD And Brilliant Podcast, you agree that Tracie Root is the sole owner of all rights and has permission to use the information provided in this form, pictures submitted, and all audio and video from the podcast recording for promotional purposes. Tracie Root has the sole right to distribute the recorded episode content in any and all media formats on all platforms worldwide, as they see fit, in perpetuity.

Please initial below.

Initial 2

Clear

By agreeing to be on BOLD And Brilliant Podcast, you commit to promoting your podcast episode via social media and/or email. Please initial below

Initial 3

Clear

Please detail any additional information you would like me to have before our recording session.

Please Subscribe, listen, and review the BOLD and Brilliant Podcast, including not only your own episode but others of interest to you. This supports us being seen by a larger audience and will bring more people to YOU!

You will be directed to book your podcast recording date after you click "submit."