TV Appearance Schedule Form

fill out form to schedule interview

Thank you for your purchase! Please fill out this form to the best of your ability so we can get your TV interview scheduled.

First Name(Required)

Last Name(Required)

Phone(Required)

Email(Required)

Title(Required)

Business Name or website you want to appear on the TV during interview(Required)

Desired city(s) to be interviewed(Required)

Dates discussed to be interviewed on or are you flexible?(Required)

Main title of the interview (max 30 words)(Required)

How do you want the host to introduce you?(Required)

Is this interview in-studio or remote?(Required)

Remote

In Person

Please provide 3-5 questions to be asked during the interview

Question 1(Required)

Question 2(Required)

Question 3(Required)

Question 4

Question 5

(Optional) Please provide links to any social media accounts that you use

(Optional) Please provide additional information you feel would be helpful

(Optional) Provide a logo, images or b-roll that can be used during the interview (this can be provided later)

Max. file size: 100 MB.