Home/I am CEO Podcast I am CEO Podcast CLICK HERE FOR MORE INFO ABOUT THE PODCAST (VIDEO & PDF)CLICK HERE TO BOOK THE INTERVIEW UPDATE: We merged our two podcasts into one now called CEO Podcasts Before we speak, you can listen to this. It gives a summary of everything. CLICK HERE FOR MORE INFO ABOUT THE PODCAST (VIDEO & PDF) VISIT THE SITE Looking forward to the interview! Complete the form below, after you complete the form, you will be forwarded to a site to schedule your interview. I am CEO Podcast Guest Name* First Last Short bio (Please in 3rd person) to read during interview - max four to five sentences*Email* Other People to NotifyDo you have a publicity manager? PR Agency? Assistant? etc. that we should copy on the e-mail we send when it goes live? Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country 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 This will not be published, it will be used for our gift. If you are not based in the US, you will receive a digital gift. A gift for being a show. We send a gift for being on the show. When you receive your gift, we would love if you could send a picture back to us with your gift and we can showcase it on our site. Website - Please include http://* This will be used for the complimentary website audit and in the show notes unless you choose a different domain below. Do you have a different domain to use for the website audit? Enter a different domain for the website audit if you would like for a different domain.What do you hope to get from the website audit?*General feedback/insightWhere my site ranks for keywordsSEO Gaps and/or opportunitiesWebsite updates and/or supportNot really interested but thanksShirt Size*SMLXLXXL (2XL)XXXL (3XL)XXXXL (4XL)A gift for being a show. We send a gift for being on the show. When you receive your gift, we would love if you could send a picture back to us with your gift and we can showcase it on our site. Any other additional social media links, book links, etc.*Please include the direct link. Headshot* Drop files here or Do you have a headshot you would like us to use? If not, we will pull one from online :-). You can also put a link to your headshot below if that's easier. How would you like to record?Audio/VideoAudio OnlyHaven't DecidedWe will record on Zoom and I will ask prior to hitting the record button (you don't have to decide now) but just as a reminder, you can do audio and video OR just audio. It's the same process. We will just repurpose the video content at a later date. Please check the following that apply (if any)* Select All Healthy CEO (Business in health, sports, fitness or wellness industry) Pod CEO (Podcast Host or creator) DMV Based Business (Washington DC, Maryland or Virgnia) B2B (Primary Clients/customers are other businesses) Previous Contributor to our sites Referred to the podcast Other OFFLINE: Are you looking for any referrals?*YesNot NowE.g. a specific type of client, connection or more podcast interviews, etc.OFFLINE: Who or what is a good referral for you?*I always try to play the connector when I can, so do you have someone that would be an ideal referral partner or someone that you would like to meet or who's your ideal client?OFFLINE: Do you have someone you would recommend being on the show?*YesNot NowWe also have a nomination form here as well you can reach at any time: https://ceoblognation.com/nominate. The person you recommend will also receive an email with a link to this form to self nominate after you submit it. OFFLINE: Recommendation's Name*Could you please recommend one person that would be a good guest on our show? First Last OFFLINE: Recommendation's Email*Could you provide the e-mail address for your recommendation? We will only use this to reach out to see if he/she might be interested in being on the show. We typically don't reach out until after your podcast goes live but if you wanted to connect earlier, that's fine too 🙂 OFFLINE: Any advice for the TRIBE?*YesNot NowAny additional advice you would want to let our I AM CEO Tribe know about? We are building a community and you can place it here or it can also be recorded after our interview.OFFLINE: Advice for I AM CEO Tribe?Any additional advice you would want to let our I AM CEO Tribe know about? We are building a community and you can place it here or it can also be recorded after our interview. OFFLINE: Interested in any of the following? Select All Digital Marketing Services Virtual Assistant Services Mastermind Group Business Insurance Payroll Services Advertising Other How else can we help?How did you find out about our podcast?*Nomination FormOnline Outreach (e.g LinkedIn, Instagram, e-mail, etc.)Referred by someoneYoung Entrepreneurs CouncilSubscriber/ListenerOther (please provide details below)Any more details about how you found out about the podcast.Any other details? If you have any problems after completing the form, click HERE after you complete the form above.