Room To Bloom Season 2 Podcast Guest Form

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If you are interested in being an interviewed guest on the Room to Bloom Podcast, please fill out this Google form. Guests will be contacted for a brief phone interview to ensure a good fit. Guests will receive a plug for their business, books, website, etc. at the end of the podcast and a link in the show notes. You must be a practicing Christian for consideration and offer biblically-based advice that can help people struggling to overcome childhood trauma that stems from family dysfunction. Thank you for your interest! Julie Rebboah

PS-There is no guest fee associated with this podcast.

Email *

Best contact phone number *

Name *

Business Information: book title, website, social media accounts, provided services, etc. *

I am a... *

Licensed mental health professional: LCSW, LMFT, LPC, or similar

Survivor

Ordained minister/pastor

Certified Trauma Specialist

Certified Life Coach

Author

Professor of theology or psychology

Christian musician/artist

Other-please specify below under other qualifications

Other:

Other qualifications, please note here:

I am interested in speaking about these proposed episode topics: *

From Embittered to Bettered (How heal from the bitterness of past trauma)

Are they difficult, toxic, or mentally ill? (How people can distinguish between these and respond in an appropriate grace-filled way)

Mental Illness is a Family Issue (how it affects everyone in the family and how they can give and receive support)

Better Boundaries (benefits of, how to set and uphold them & what to do when they are violated)

Gaslighting; You're Not Crazy! (what is gaslighting, and how to deal with it when it happens)

Learning to trust (how to identify safe people, learn to trust them, and God)

Space for Grace (for ourselves and others when relationships are unhealthy, forgiveness)

Abandonment (overcoming an abandonment wound and relying on the Heavenly Father)

Survivor Story (What's your story? How did God heal you from a traumatic childhood? How are you using it for God's glory?)

Safe People (how to identify people who are safe as friends, mentors, or as a potential spouse)

ACEs (Adverse Childhood Experiences and strategies to overcome the odds)

Perfect Heavenly Father (embracing your identity as a child of God and relying on your Heavenly Father after experiencing childhood trauma)

Control (Why do people feel the need to be controlling after trauma? How can they overcome this?)

Other: Please specify below what you feel led to speak about.

Required

Other topic:

If you are a survivor of childhood trauma, please write a brief paragraph about the nature of your story and God's role in your healing. (limit 1 paragraph)

Are you open to being on a guest on future seasons? *

Yes

Maybe, if the topic is the right fit.

Are you a practicing Christian? *

Yes

What is your denominational affiliation? *

Do you have a headshot to share for publicizing your episode? *

Yes

Time Zone *

Pacific

Mountain

Central

Eastern

Other:

Do you have any availability constraints? What do we need to work around time wise? *

Do you consent to having both the audio and video portions of your interview being recorded and used? *

Yes

Do you irrevocably authorize From Bud to Bloom to capture, record, utilize and release your name, image, voice, biography, and materials through various media channels such as, but not limited to, Instagram, YouTube, and various podcast platforms? Do you authorize the agency to promote your business and attach links to your website, products, or services? Do you agree that there will not be any form of compensation such as royalties or payments now or in the future? Do you agree that From Bud to Bloom is the sole owner to the rights and recordings of the interview worldwide in perpetuity? *

Yes

I understand that I will receive episode promotional materials, and a link to the episode that I am permitted to use on my own social media accounts and website, if I so choose. *

Yes

Do you hereby release and discharge From Bud to Bloom from any and all liability arising out of or in connection with the making, producing, reproducing, exhibiting, distributing, publishing or transmitting by any means the Program to the fullest extent of the law and waive all legal and equitable claims in relation to the Program whatsoever? *

Yes

E-signature: *

Date: *

YYYY

Thank You!

I sincerely appreciate your willingness to be a guest on my podcast. May God's glory shine a light to those in need of wisdom and direction. My plan is to secure guests spring of 2024, begin recording as guests are available, and broadcast is planned for late summer/early fall 2024. Episodes will be kept to approximately 45 minutes. Guests will be provided with a list of proposed questions prior to recording to guide discussion.

I look forward to reading your submission. I will contact you as soon as I am able for further information about the possibility of collaboration. Blessings, Julie Rebboah

A copy of your responses will be emailed to the address you provided.

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