Podcast Interview Interest Form
So glad you made your way here. I can't wait to talk to you about your experiences, work, joy, and life in Appalachia.
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How would you like me to contact you to schedule? If you list phone, please provide phone #
What dates/times generally work for you for an interview?
Introduce yourself (Name & Pronouns)
Where are you in Appalachia?
What would you like to be interviewed about?
Do you want/need to be interviewed under a pseudonym? If yes, no questions will be asked and I will do my best to mask your voice but I cannot guarantee anonymity.
Would you like to bring anyone along with you?
Is there any area that you would like me NOT to ask you about on the interview? *This will not be mentioned or printed in any show notes.*
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This form was created inside of Christina R. Perkins LCSW.