ICC Podcast Info Request Form
You are responding to: Gina Jorgensen  
Please call or email with questions!
414-380-0808  
iccmkepodcast@gmail.come
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Email *
Your name: *
The name of your group or organization that you are connected to if applicable:
Your phone number: *
Best time to reach you for further information: *
Required
Possible people to interview: Include yourself if you are one or you will be interviewed alone: Please add first and last names. *
Please share topics that you are interested in talking about with a short description that we can create questions around: *
How would you title this episode ? *
Please provide a short bio statement that will be read to introduce you and others and/or the group or organization you will be representing if applicable:
Does your organization have a website we can reference?  Please provide the link.
What is your availability to be interviewed? *
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What is the best time for you to be interviewed? *
Time
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Anything else you would like to share?
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