Special Guest Form
Sign Up To Join A DIVA At The Dining Table. Promote Your Business, Brand, Event and Products.
Street Address Line 2
State / Province
Postal / Zip Code
Name of your Manager or Publicist including email and contact number?
Why do you want to be on the television show?
Topics you want to discuss
Please share any links to past speaking engagements and/or product links
Please attach your photos and documents including a high-resolution headshot and logo.
How did you hear about us?
Referred by someone
I'm an online fan / subscriber
Please verify that you are human
Any questions or concerns?
Should be Empty:
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