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Name of the Organization
Website
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If In-Person, What is the Event Address?
Exact Number of Hours the Speaker is Expected to be in Attendance, Including Early Arrival or Login, Q&A and Participation in any Pre-Event or Post-Event Meetings and Discussions.
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Will Hotel and Travel Expenses be Reimbursed
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Who Else is Speaking and What are their Topics?
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Podcast Guest Interest Form
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Name
Email
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Short Bio
Topic you would like to discuss
Why do you want to be on the David Nilssen Podcast?
Social Media (URL and Handles)
Would you like to offer a Gift/Download/Incentive for the Listeners? If yes, please provide details.
Please Respond to the Following
I understand that I am consenting to the recording and distribution of reproduction(s) of my voice, photograph, likeness, and performance as part of my participation on the David Nilssen Podcast. David Nilssen is the sole owner of all rights in and to the Program, and the recording(s) thereof, for all purposes; and that Producer has the unfettered right, among other things, to use, exploit and distribute the Program, and my performance as embodied therein, together with my name, sobriquet, biographical sketch, photograph or likeness (including, without limitation, any photographs or other material provided to the Producer by me or my representatives), in any and all media or formats, throughout the world, in perpetuity.
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