Podcast Guest Application Form Thank you for your interest in being a guest on our podcast. Please fill out this form and we'll reach out to you via email if we think you'd be great for an upcoming episode. Name* First Last Email* Business Website* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country We might just send you a nice little thank you gift 🙂 Preferred social media profile URL* Your BRIEF bio (max 4 sentences please):*List 2-3 uncommon processes or strategies you have used to grow your business that would make interesting topics for our listeners. i.e. What have you done that you can teach other startup business owners?*Alternatively, share a personal shift or perspective that you went through that created a significant impact on your business resultsIs there a specific product/service/event you'd like to promote during the show?* E.g. a new book or product launch, campaign, celebration, etc. (if none, say N/A)Please provide a high-resolution headshot to utilize in the podcast promotional materials.* I'll provide a download link I've emailed the photo to [email protected] We'll be using the image for promoting your episode.Link to high resolution profile photo/headshot Are you happy to share your Podcast interview with your audience (email list, social media) when it airs?* Yes No We'd love your support to get your episode out to as many people as possible! Media/Audio release I hereby voluntarily and without compensation authorize voice recording(s) to be made of me. I hereby give permission to Bean Ninjas to use, reproduce, and distribute the voice recordings, including my name and submitted photo(s). I hereby agree to release Bean Ninjas from any claims, damages or liability arising out of such use or distribution. I understand that the use of my name, likeness, and voice recordings will be primarily for the purposes of commercial use, education and/or promotion by this organization. I have read and understand the foregoing and I consent to the use of my picture and/or voice as specified for the above-described purpose(s). I further understand that no royalty, fee or other compensation of any character shall become payable to me.Consent - Media Release* I agree to the above media/audio releaseConsent - Privacy* I grant Bean Ninjas permission to collect and store my data as per the BN Privacy Policyhttps://beanninjas.com/privacy-policy/ Δ