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Life & Death Roadshow Event
Life and Death in the C-Suite Book Signing
Name
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First
Last
Email
(Required)
Company
(Required)
Title
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Brief Bio
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Possible Dates for Event
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What Social Media Platforms Do You Use?
LinkedIn
Twitter
Facebook
Instagram
LinkedIn
Please provide a link to your LinkedIn profile
Twitter
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Facebook
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Instagram
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Please Upload High-Res Photos
Company Logo
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Max. file size: 49 MB.
Author Head Shot
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Max. file size: 49 MB.
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Name
*
First
Last
Email
*
Phone
Company
*
Title
*
VP
Founder
Co-Founder
Investor
President
CEO
CMO
COO
CFO
Other
What is your Annual Business Revenue?
Less than $1M
$1M - $2M
$2M - $5M
$5M - $10M
$10M - $25M
$25M +
How many Employees do you have?
5 or less
6 - 10
11 - 25
26 - 100
101 - 500
501 +
Opt-in to our email communication to receive information about our events, insight, news and platform updates.
*
Yes
No
Phone
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MEMBER NAME
*
First
Last
MEMBER EMAIL
*
DO YOU CURRENTLY HAVE A PODCAST?
*
Please select one
YES
NO
NO - BUT I'M INTERESTED
DO YOU HAVE AN IDEA FOR A PODCAST?
NO
YES
PODCAST NAME
*
POTENTIAL PODCAST NAME
*
RSS FEED
*
Every RSS Feed is slightly different – so if you don't know yours, you can find your hosting provider’s instructions here: http://support.megaphone.fm/en/collections/126940-redirecting-to-megaphone
NUMBER OF EPISODES
*
RELEASE DATE OF NEXT EPISODE
MM slash DD slash YYYY
EXPECTED LAUNCH DATE FOR PODCAST
MM slash DD slash YYYY
WHAT IS THE GOAL OF YOUR PODCAST FOR LISTENERS?
IN WHAT WAYS WILL YOUR PODCAST SUPPORT YOUR BUSINESS?
WHO IS THE AVATAR FOR YOUR PODCAST?
"AVATAR" is podcast talk for target audience
WHAT QUESTIONS DO YOU HAVE FOR C-SUITE RADIO THAT YOU'D LIKE FOR US TO FOLLOW UP ON?
DOES ANOTHER USER NEED ACCESS TO YOUR PODCAST?
*
YES
NO
WHAT IS THEIR ROLE?
*
Producer
Booker
Audio Engineer
Co-Host
Host
THEIR NAME
*
First
Last
THEIR EMAIL
*
DOES ANOTHER USER NEED ACCESS TO YOUR PODCAST?
*
YES
NO
WHAT IS THEIR ROLE?
*
Producer
Booker
Audio Engineer
Co-Host
Host
THEIR NAME
*
First
Last
THEIR EMAIL
*
CAPTCHA
X
X
Name
*
First
Last
Email
*
Phone
Company
*
Title
*
VP
Founder
Co-Founder
Investor
President
CEO
CMO
COO
CFO
Other
What is your Annual Business Revenue?
Less than $1M
$1M - $2M
$2M - $5M
$5M - $10M
$10M - $25M
$25M +
How many Employees do you have?
5 or less
6 - 10
11 - 25
26 - 100
101 - 500
501 +
Opt-in to our email communication to receive information about our events, insight, news and platform updates.
*
Yes
No
Comments
This field is for validation purposes and should be left unchanged.
X
Name
*
First
Last
Email
*
Phone
Company
*
Title
*
VP
Founder
Co-Founder
Investor
President
CEO
CMO
COO
CFO
Other
What is your Annual Business Revenue?
Less than $1M
$1M - $2M
$2M - $5M
$5M - $10M
$10M - $25M
$25M +
How many Employees do you have?
5 or less
6 - 10
11 - 25
26 - 100
101 - 500
501 +
Opt-in to our email communication to receive information about our events, insight, news and platform updates.
*
Yes
No
X