Build. Change. Impact. Podcast Interview Form

Name*
First Last
Email*
Phone*
Website*
Short Bio (for introduction)
Image of you (headshot preferred)
Max. file size: 2 GB.
Business logo image
Max. file size: 2 GB.
If you want to be prepared these are some of the things we’ll be talking about in your business owner journey.

:: Why did you start your business?

:: What did your business look like when you started?

:: What does your business look like today?

:: Biggest struggles?

:: Biggest achievements? What are you most proud of?

:: When did you really see/know that what you were doing with your business was making an impact (for you, your family, your community, etc).
Why did you start your business?
How does your business look different today than when you started?
Was there a specific moment you realized your business was making a difference and having an impact? (Could be with clients/customer, family or community) If so, please describe.
Other topics you'd like to discuss. If there is anything specific you want to make sure we cover please let us know here.
Do you have any freebies you'd like to share with our audience?
Are you comfortable with video/audio or audio-only? *
Untitled*
- I will have a quiet environment to record.
- I agree to send out an email mention to my list and a social media promotion during week of release.
- I agree to the release and promotion of this interview on the Build. Change. Impact. Podcast
- I understand that the host reserves the right to determine when they publish my interview.
- I recognize the host reserves the right to refuse to air my interview should complications arise.

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