Podcast Request

Name of Podcast:

Podcast Type

Online

In-Person

Link to Podcast:

Time Zone of Podcast:

Name of Host:

First Name

Last Name

Date(s) requested:

Length of Interview:

Topics:

Other helpful information:

Main Contact

Phone

(###)

###

####

Media

Inviting party agrees to supply a copy of any audio/video recordings

Yes

Sessions will be recorded

Audio

Video

Both

None

Anticipated Release Date

YYYY

Channels to be released on

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