About The Interviewer/Publication:

Name Of Organization/Publication *

Name Of Interviewer(s) *

Email Address *

Phone Number *

Target Publication/Platforms: *

Purpose Of The Interview/Topic *

What Platforms Are You On?

How Many Followers Do You Have Across All Your Platforms? *

Please Share A Link To Your Largest Social Media Platform *

Please Share A Link To A Recent Piece Of Content *

Please Share A Bio/Summary About Yourself *

Please Upload A Short Video Of Why You Want Me On Your Platform *

About The Interview Details:

Proposed Date And Time *

Preferred Interview Method (Phone, Video, In-Person, Zoom) *

Estimated Interview Length *

Will The Interview Be Recorded? (Yes/No) *

Yes

Will The Interview Be Published? (Yes/No) *

Yes

Do You Have A Link To A List Or Google Doc Of Potential Questions Or Topics You Would Like To Share? (Optional, But Highly Recommended)

Additional Information:

Any Specific Areas You Would Like Me To Focus On Or Avoid? (Optional)

Any Other Relevant Information? (Optional)