TEMPLATE - Techfluence Content Creator Submission Form:
Many thanks for your interest in participating in this Techfluence YouTube Campaign on behalf of the XXX from XXX. To be considered for this campaign, please fill out the form below.

For more information on the product, please visit XXX

Please note, filling out this form does not guarantee you will be selected for this campaign, but I promise we will get back to either way.

If you have any questions, please email barry@techfluence.us. Thanks again for allowing us to send you these opportunities.

Email address *
1. Please provide your first and last name. *
Your answer
2. Please provide your shipping address for the product and your phone number. *
SKIP THIS QUESTION IF YOU HAVE PREVIOUSLY FILLED OUT THIS FORM FOR A DIFFERENT TECHFLUENCE CAMPAIGN AND THE INFO HAS NOT CHANGED.
Your answer
3. Please provide the name of your YouTube channel. *
SKIP THIS QUESTION IF YOU HAVE PREVIOUSLY FILLED OUT THIS FORM FOR A DIFFERENT TECHFLUENCE CAMPAIGN AND THE INFO HAS NOT CHANGED.
Your answer
4. Please provide a link to your YouTube channel. *
Your answer
5. Please select the types of content you are potentially able to produce for this campaign.
6. Please use the space below to tell us more about the type(s) of video(s) you can potentially produce for this product, including any specific suggestions you have. (Optional) *
Your answer
7. Will you be promoting your video on social media?
8. If you answered yes to Q.7, please provide links to the social profiles where you will be promoting your video.
SKIP THIS QUESTION IF YOU HAVE PREVIOUSLY FILLED OUT THIS FORM FOR A DIFFERENT TECHFLUENCE CAMPAIGN AND THE INFO HAS NOT CHANGED.
Your answer
9. If you are planning on posting your video on a blog or other site outside YouTube, please provide a link to the site where it will be posted.
SKIP THIS QUESTION IF YOU HAVE PREVIOUSLY FILLED OUT THIS FORM FOR A DIFFERENT TECHFLUENCE CAMPAIGN AND THE INFO HAS NOT CHANGED.
Your answer
10. Would you like to request compensation for your video?
NOTE - Requesting compensation may impact whether or not you are selected for this campaign. However, if the client elects not to offer compensation, we will let you know and give you an opportunity to amend the request. Of course, compensation of any type must be disclosed in your video. Feel free to submit a Media Kit or Rate Card for us to keep on file to barry@techfluence.us at any time.
11. Please use the space below if you would like to provide pricing for specific types of videos. (Optional)
Your answer
12. Are you interested in an affiliate marketing program where you are provided a link for your video description and you have a chance to earn revenue if a viewer uses the link and purchases the product?
13. Are you interested in running a giveaway/contest to help promote your video?
14. Do you agree to allow getgeeked Media / Techfluence and our client to review your video prior to posting? *
NOTE - You retain the right to publish your video regardless of whether it is negative or positive.
15. Do you agree to provide certain key metrics from YouTube Analytics one week after posting your video, including click numbers for any links provided by the client and included in your description? *
Metrics we are interested in receiving include Average View Duration, Total Time Watched, Average Percentage Watched as well some key demographics such as gender distribution, age distribution, device viewed on, location, etc. These can generally be captured as screenshots and sent to us.
16. Do you agree to allow getgeeked Media / Techfluence and our client the right to promote and share your video? *
NOTE - You maintain all legal rights to your video.
17. Do you agree to send us links to your video when it is posted and attempt to also send links to any social media posts promoting your video?
18. For this program, we are asking for videos to be posted by XXX after receiving the product. Do you agree to this timeline? *
Please use the space below to share any additional information you would like us to have.
NOTE - If you have questions, please send them via email to barry@techfluence@getgeeked.us
Your answer
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