The Fuel Your Legacy Show Registration Form

The Fuel Your Legacy Show Registration Form

Please fill in the form below.
Full Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Personalized Podcast Thumbnail

I need a picture that will easily fit this thumbnail where I am currently.
Image to Display on podcast cover that will fit nicely where I am in the picture.

Browse Files

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Attach your One Sheet if you have one.

Browse Files

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THIS PODCAST WILL BE VIDEO & AUDIO RECORDED

PLEASE PREPARE ACCORDINGLY.
The goal of the podcast is to share habits, mindsets and behaviors you have developed that will enable the listener to Build a meaningful legacy?
What focus/topic do you feel you can add the greatest insight for building a legacy?*
Please share your biography?*
How would you like to be introduced on the podcast?*
What two books have taught you the most about your selected topic?*
Suggestions or topics you would like to be included in the Podcast?
Who would you recommend for me to have as a guest on the Fuel Your Legacy Show?
Please Put all of the links that you would like to have appear in the show note such as: website, social media links, offers, books etc.
THIS PODCAST WILL BE VIDEO & AUDIO RECORDED

PLEASE PREPARE ACCORDINGLY.
I will commit to create an: Email notification for my/your email list, a thumb nail promotion picture, a short facebook/instagram live video (which will also go on my fb story), and a post on linked in.
Will you commit to sending out a provided template about your upcoming episode to your email list?

YesNo
Doing a short fb live/instagram video about your episode?

YesNo
Put that video also on your fb and instagram stories?

YesNo
Comment and share on my posts on fb and linked in about your episode?

YesNo
THIS PODCAST WILL BE VIDEO & AUDIO RECORDED

PLEASE PREPARE ACCORDINGLY.
Should be Empty:

The Fuel Your Legacy Show Registration Form

Personalized Podcast Thumbnail

THIS PODCAST WILL BE VIDEO & AUDIO RECORDED

The goal of the podcast is to share habits, mindsets and behaviors you have developed that will enable the listener to Build a meaningful legacy?

THIS PODCAST WILL BE VIDEO & AUDIO RECORDED

THIS PODCAST WILL BE VIDEO & AUDIO RECORDED