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Interview Request Form

Thank you for expressing interest in being interviewed on one of our programs. The form below notifies our Local and Roving Hosts. Please provide the following information to assist our Host in preparing for the interview and setting up a time with the Guest.

We look forward to talking to you and helping promote your business, book or region.  Before submitting the form, please read our Terms and Conditions.

The name of the person being interviewed
The name of the person being interviewed
This email will be used to schedule the interview and request additional information if required
This is the telephone number the Interview Host will use to contact the Guest and conduct the Interview. - Please consult: Preparing for an Interview
We have different outlines to guide our Hosts through different types of Interviews, please select the most appropriate.
A short meaningful title to be used for the article or Podcast episode
The name of the organization that the guest represents that will be the focus of the interview
Please select the most appropriate Industry Sector that best describes the Organization
You selected 'Other' Industry Sector - Please define.
The URL of the Organization or other appropriate website
Country of the organization that is the focus of the interview.
What is the closest Major City to the Organization?
What is the Region associated with the Organization? e.g. Napa Valley, Barossa Valley, Marlborough
Enter (or Copy/Paste) biographical information about the guest and the organization here. Even if you submit additional information below, please provide text here. This will be used to introduce the guest and will form part of the 'Show-Notes'

High resolution image (approx. 500x300px) for featuring the article
Other images to be used with this article.
If you have any additional notes or message to convey please enter it here

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