Name

First Name

Last Name

Phone

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Instagram Handle

Current Job Title

Company Name

Work Industry

Marital Status

Number of Children & their Ages

What is your unique story as a wife, mother, and/or professional that you would like to share?

What challenges have you faced balancing these roles, and how have you overcome them?

What lessons or insights would you like to share with our audience?

If there are any other specific topics themes you'd like to discuss on the podcast?

Have you been a guest on other podcasts or media outlets?

Yes

Availability for recording

Do you consent to being recorded and having your episode published?

Yes

Would you be willing to share your episode on your own platforms?

Yes

How did you hear about this podcast?