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Podcast Request Form
Thanks for inviting Emily to be on your podcast. Please complete all fields below. We will consider your request, and we'll follow up with you if we can make it work.
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Email
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Contact Name
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Contact Email Address
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Name of Podcast
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Link to your website and/or podcast:
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Number of episodes to date:
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Number of monthly downloads per episode:
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Description of your audience:
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Previous guests interviewed on your podcast:
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Length of time needed for interview:
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Requested Date to Record
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