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Personal Information

Your First Name(Required)

Contact Information:

Type of Phone(Required)
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
US Number: I will reach out to you to set up an interview
International Address
INTERNATIONAL Number: I will reach out to you to set up an interview
Canadian Address
CANADIAN Number: I will reach out to you to set up an interview

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., https://themillenniumbeat.com/ ) NOT @THEMILLENNIUMBEAT
List all Information if applicable
e-Mail
Website
 
Podcast
Facebook
 
Instagram
 
YouTube
Twitter
TikTok
 
LinkTree
Store
 
Things to do(Required)