Last Name *

First Name *

Best way to contact you to setup the live broadcast? *

Short bio or background info so I can introduce you. What are the top 3 things you want to share? *

Why space? *

Where do you MOST want to Explore? (you can only choose one) *

What is the one thing you want to eat as you explore this location? *

Who would you want at your dinner table and Why? (give at least one person - don't forget the why!) *

Which are you? *

What is your favorite dish that you make or eat at home? *

What is your favorite type of food? If you could only eat one type of food for the rest of your life, what would it be? *

What would be your go-to drink in space? *

What’s your favorite meal of the day? *

What is your favorite celestial object and why? *

Are you a snacker? *

Do you have space themed parties? *

Could you eat like a Martian? (combining Freeze-dried food with local fresh ingredients) *

Any advice on space, food, and sustainability for our audience?

I understand that this is a live broadcast. I grant Sian Proctor (Psy’s Creations, LLC) the irrevocable right to use my answers along with my name, likeness, image, voice, appearance and/or performance as captured by written, photographic, audio and/or video means for the Space Snacks show (known as the “Product”) for release on and/or reproduction in any medium such as a website, Facebook Live, YouTube Live, Instagram Live, etc. along with the recording. I acknowledge that any use of the Product may be made without compensation. Because this is a live broadcast, I waive any right to inspect, approve, and/or otherwise control the use of the Product. I acknowledge that my name and identity may be revealed in the Product or by descriptive text or commentary. *