Empowering Her Podcast Guest Form

Name *

First

Last

Phonetic pronunciation of your name

Business/ Brand Name

Email *

Website / URL

Social Media Accounts

Provide your social media accounts information for your brand

Why do you want to be a guest on the Empowering Her Podcast? *

Your bio (Max of 5 sentences) *

What is your key message(s) *

Would you be promoting any specific product/service/ or event? *

Provide details if yes.

Are you willing to re-share your podcast interview on your brand channels (social media, CRM, website etc)? *

Yes
No

Are you interested in writing a guest blog post on Godlywoman911.com or fsbbrand.com? *

Yes
No

How did you hear about us? *

Search Engine
I am a current listener
Someone thought I would be a good fit
Podcast advertisement

Consent Agreement

I authorize and consent to Empowering Her Podcast, and its affiliate brands (Godly Woman 911 and From Small Beginnings Ltd), herein referred to as Company, to video and voice recording(s) of me without compensation. I hereby give permission to the Company to use, reproduce, and distribute the voice recordings, including my name and submitted photo(s). I hereby agree to release the Company from any claims, damages or liability arising out of such use or distribution. I understand that the use of my name, likeness, and voice recordings will be primarily for the purposes of commercial use, education and/or promotion by the Company. I grant the Company permission to collect and store my data as per the Privacy Policy found on http://www.godlywoman911.com. I have read and understand the foregoing and I consent to the use of my videos, picture and/or voice as specified for the above-described purpose(s). I further understand that no royalty, fee or other compensation of any character shall become payable to me.

Yes
No