Trill Mom's Pre-Interview Form

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Name *

Name You Would Like To Be Called *

Phone number *

Are you comfortable receiving text messages? *

Yes

Maybe

Email Address *

Would you like to be added to our mailing list? *

Yes

Maybe

Tell us about yourself. *

What is unique about your kids/your mothering journey? *

What are you an expert at? What would you like to talk about? *

Is there anything you're uncomfortable discussing? *

Do you have anything specific you'd like to promote? Upcoming events? Products? Services? *

Are you a part of any women's groups? If so, please list them below. *

What topics should we cover in future episodes? *

What would you like to see Trill Moms to produce? *

Youtube Content

Television Content about Modern Mothering

Products to Support Mothers

Mom-centered events

Other:

Required

Social Media Links *

Additional comments/feedback?

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