Interview Form
Hi there! Thank you for accepting the invitation to be a featured guest on one of my shows! I look forward to getting to know you and learning about what inspires you.

I appreciate you taking the time to review and complete this form. Your answers will help me to promote the show on social media and to prepare for the interview. I am grateful for this opportunity!

Please be sure to read all of the information on set up and requirements, as well as the agreement.

Please enter your full name and screen/blog name, if applicable: *
Your answer
Do you prefer to be called by your first name or a nick-name? What name would you like me to use on the show? *
Your answer
What is your area of expertise or interest? *
Please check all that apply:
Tell me a little bit about yourself and what would you like to discuss or promote on the show? *
What are you most passionate about? Are you working on any projects you would like to talk about? Enter shameless plug here...
Your answer
When you aren't working, what do you like to do for fun? *
Do you have a hobby, what is your favorite pastime?
Your answer
What are some topics that you would like to discuss? *
Some ideas/examples: health/wellness, humanitarianism/volunteerism, books, food, beauty/fashion, blogging/social media, travel/entertainment...what really floats your boat?
Your answer
Who or what has inspired you in your life? How has this inspiration changed you or motivated you to be the person you are today? *
The intent of Inspiring Adventures with Miz Meliz is to share what has inspired successful people to push themselves to the next level. You are being invited to be on the show with me to help inspire others to find their passion and live their purpose.
Your answer
How can my audience connect with you? *
Please list your website, email, Twitter, Facebook, any contact information and links that you would like to share.
Your answer
Please enter your email address here: *
This will be used to send reminders and updates about the interview, when the show broadcasts online, and upcoming shows.
Your answer
I will schedule a one on one interview with you for "Inspiring Adventures". You also have the option to be a guest on "Last Night's Show with Miz Meliz" which is a 30 minute variety talk show. We broadcast live on Saturday nights at 6:30 ombré Pacific. There may be 1-3 guests on each episode. We respect and appreciate your valuable time! Everyone who shows up gets on air. When we receive this commitment form, we start promoting. Please let us know asap if you need to reschedule or cancel. If you would like to be a guest on this show, please indicate the date here:
Please send your bio, a headshot photo and 1-3 pictures that can be used on my blog, social media, and on the video for the broadcast and promo. *
Email jpegs to
Unless other arrangements are made between us, the interview will be broadcast live via Facebook. To record the interview, we will be using which works best when connected online through Facebook. You will need to have a computer with video webcam, headphones (or earbuds) with microphone, and internet wifi. It is also required that you use Chrome as the browser. You will be sent a link in Facebook messenger that will connect us one hour prior to the interview. You must have a Facebook account and you must be using Chrome, if you don't please tell me in advance so we can make other arrangements. *
Make sure there is plenty of lighting, that you have something to drink nearby, be seated comfortably and turn off any other applications running on your computer. Don't forget to silence your phone. I do not interview on other platforms. Please plan ahead and check your equipment. We will meet online one hour prior to the interview time to test connection, lighting and sound. When the interview airs live, it is wonderful if you invite your friends and fans to see it. The best way to do that is to let them know to watch at the time and date of the show. Once the show begins, you will be able to share it directly to your own profile page, group or fan page on Facebook. Viewers can interact by leaving comments and asking questions. I will be happy to walk you through this at the time of the interview. *
How do we know each other? Please remind me how are we affiliated? *
Please check all that apply or add something. Thanks!
Let's work together to get the word out about Inspiring Adventures
Help me out by sharing these links, I will be sharing your links, too!
Please enter your mailing address
Sometimes I might get it together enough to send you a little something in the mail and I might even get around to sending a Holiday card. I promise not to add you to any mailing list or share this information with anyone.
Your answer
Additional Services Available
After the interview airs on, it will be edited and posted on You Tube. We may add music, voice-over, credits, titles, captions, and links. In many cases the social media resources and influential reach is quite substantial and may help in getting your message seen and heard by the public. If you would like assistance with a campaign to target a particular audience, please indicate services that you are interested in and we will be happy to walk you through the process.
Contractual Agreement *
By agreeing to appear as a featured guest, I accept the terms of the interview, whereas my image, voice, photos, web presence, products, and information that I share will be broadcast live as well as recorded. The recording of the interview will be the property of Melissa Reyes with all rights reserved. The live broadcast will be aired on Facebook on MizMelizLA as well as BubblrMedia and/or Adventures with Miz Meliz and/or A Year in Action page. The uncut replay of the live broadcast will be embedded on and may be shared via social media such as, but not limited to Twitter, LinkedIn, Facebook, Instagram, Snapchat, Triberr, and Pinterest.
MizMeliz/BubblrMedia Release Form *
I have read, agreed to, signed, and dated the attached BubblrMedia Talent/Featured Guest Release Form (pictured below) and I understand that the interview will be scheduled when the form is submitted.
Talent/Guest Release Form
Please confirm that you have read the entire agreement and agree to the terms and conditions herein. Entering your name in the space below will serve as your signature. *
Your answer
Phew!! That was a lot! Thank you so much for completing this!! Now, for the fun part! I will confirm with you and either myself, Cindy or Anna, will be in touch with you to schedule the date on a Google calendar and we will send you a message in Facebook messenger and/or email with more details. Contact me anytime if you have questions, or enter anything that comes to mind in the space below. Thanks so much!!
Your answer
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