**Podcast Guest Information Form**
Thank you for agreeing to be a guest on the "Grandparents Raising Grandchildren" podcast. Please complete the following form to help us prepare for your appearance.
**Personal Information**
1. **Full Name:**
2. **Preferred Name (if different):**
3. **Email Address:**
4. **Phone Number:**
5. **Mailing Address:**
**Professional Information**
6. **Current Title/Position:**
7. **Organization/Company:**
8. **Website:**
9. **LinkedIn Profile:**
10. **Other Social Media Profiles (please specify):**
**Background and Expertise**
11. **Brief Bio (150-200 words):**
12. **Relevant Experience and Expertise:**
13. **Publications (books, articles, etc.):**
14. **Previous Podcast or Media Appearances:**
**Podcast Details**
15. **Topic(s) You’d Like to Discuss:**
16. **Specific Insights or Stories You’d Like to Share:**
17. **Questions or Topics You’d Like Us to Avoid:**
18. **Special Equipment Needed (microphone, headset, etc.):**
19. **Preferred Date and Time for Recording:**
**Permissions**
20. **Do you grant permission for this episode to be recorded and distributed across various platforms?**
- Yes
- No
21. **Do you grant permission for us to use your name, likeness, and biographical details in promotional materials?**
- Yes
- No
**Additional Information**
22. **Any Additional Comments or Information You’d Like to Provide:**
**Agreement**
By signing below, you agree to participate in the "Grandparents Raising Grandchildren" podcast and consent to the recording and distribution of the episode.
**Signature:**
**Date:**
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Please return the completed form to laurabrazan@grandparents-raising-grandchildren.org at your earliest convenience. Thank you!