Full Name: *

Email Address: *

Phone Number (for coordination only): *

Business Name: *

Business Website: *

LinkedIn Profile: *

Were you invited by Justin or a member of his team? *

YES - I have a special code

No - here to apply

What range is your current net worth?

Do you have a podcast? *

Yes

Other Social Media Links: *

Brief Introduction Bio *

Headshot Image *

Why You?

List 2-3 key wins/milestones (e.g., revenue growth from $X to $Y, successful exit valuation, client results) with brief details. *

What 2-3 topics could you discuss in depth (e.g., scaling teams, navigating exits, growth hacks for $10M+ businesses)? *

What do you hope to achieve from this appearance (e.g., networking, audience growth)? *

Logistics

Have you been featured on podcasts or stages before? *

Please consider the following questions for quality. We recommend at least 1080p devices. Phone cameras should not be used for an interview.

Do you have a professional microphone (e.g., USB mic like Blue Yeti) and a quiet, distraction-free space? *

Do you have a high-quality camera for video recording? *

Are you willing to share the episode with your audience via email or social media once it goes live? *

Yes

I agree to the terms & conditions provided. By providing my contact information, I agree to receive communications.