Interview Request – Connie Bennett, Your Bounce-Back Boldly Guide™

Interview Request

For Members of the Media or a Podcast

If you are a member of the media or a podcast host, answer these questions, please.

Name of Your Media Outlet*
Focus of Your Show, Segment or Story*
When Would You Like to Interview Me (start)*
MM slash DD slash YYYY
When Would You Like to Interview Me (end)*
MM slash DD slash YYYY
Who is Your Audience (Age)
Who is Your Audience (Sex)
Who is Your Audience (Interests)
Who is Your Audience (Profession)
Size of Your Audience
Website URL
Who was one recent expert, who wowed you during the interview?
Link to the Wow interview, please, if possible
How Can I Reach You? Email Address
Phone
Are you on a tight deadline?
- Yes
- No
If so, how can I help you?
Phone
This field is for validation purposes and should be left unchanged.

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