Be A Guest Form


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Personal Information

Your Name(Required)

Contact Information:

Type of Phone(Required)
After reviewing your request to be a guest, I will send you a "Thanks for choosing to be a guest" letter with dates/times to do a show with you.
Type of e-Mail(Required)
Is you e-mail a personal or business account
I will use this e-Mail only to send you a confirmation, interview reminder and your show has aired letters.

Only fill out the address where you will be doing the show from (One is required)

U.S.A. Address
International Address
Canadian Address

How Do You Want To Be Interviewed?

*If in-person is chosen, I might be unable to do it due to location and time. We will have to do an alternative way. But I will keep that in mind when I'm doing road trips in your area.

When Are You Available To Be Interviewed?

What Days of The Week Are You Available(Required)
What Time of Day Works Best For You?(Required)

Social Information

Please provide any links associated with the following categories below. (i.e., ) NOT @THEMILLENNIUMBEAT
List all Information if applicable
Things to do(Required)