Chaos to Clarity Reset Podcast

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If the intention and message of the Chaos to Clarity Podcast aligns with your story and message, I invite you to fill out an application to join the show.

Before applying, please learn more about the podcast here https://www.lisagumieniuk.com/podcast-guest/

Email *

Your full name *

Your business name

Bio/Summary (in third person) about yourself, accomplishments, awards, what you’re known for etc. (up to about 100 words) *

Proposed Podcast Topic Name *

What is a personal Chaos to Clarity story you’d like to share with the audience? *

What are 5+ questions I can ask you about your story? *

What was your Chaos to Clarity AH-HA moment? *

What was a Key Gift or Lesson you gained from your experience? *

What are you 1-3 key tips for listeners? *

What else would you like me to know about you / what else would you like to share with me?

Is there somewhere I can find out more about you to research you and your story in preparation for the podcast?

CONTACT DETAILS

Please include the Name + the complete URL.

Website

Facebook Page

Facebook Group

Instagram

Twitter

Youtube

Podcast

Other Social Media

Do you have any special hashtags

Contact info for Lisa’s reference only

Mobile

Postal Address (for a thank you message)

IMAGE REQUIREMENTS

• Please email at least 2 different JPEG or PNG images of yourself to lisa at lisagumieniuk dot com
• FYI, keep in mind that the background in your image will be removed by me (see below example)

Sample Image

MORE INFORMATION

For more information about the Podcast including the below head to Podcast Guest HERE: https://www.lisagumieniuk.com/podcast-guest/

• About the Podcast
• About me
• Podcasting Process
• Sample Interview Flow
• Prep Guide

AGREEMENT

Please advise at any stage in advance if you are no longer able to take part in the Podcast.
Once the recording is complete, it will be made available on a number of my social media platforms, and may be repurposed and converted into other materials that may be made available via various formats for users.
The podcast will be promoted on all my social media sites, website and other locations and you are welcome to share these links with your audiences, once available.
Below are a few questions to confirm your consent sharing your intellectual property and online media links, as well as your agreeing to promote the summit/your recording etc.
• By signing this form, I agree that my name and headshot and all recorded content can be used by me for promotion.
• By signing this form, I agree that the content of this episode is owned by Wellness for Life Australia, Trading as Larimar Wellbeing (my company).
• By signing this form, I agree no funding is provided for my contribution to this podcast.
• By signing this form, I agree to promote the Podcast, once the segment/interview is aired to my email list and social media platforms.

I agree to the above *

YES, I AGREE

Required

It's important for those who are going to be on The Chaos to Clarity Podcast to understand what it's about, the target audience and process as well as connect with me. Have you... *

Listened to an Episode and are across the Guest Podcast Process for Format

Connected with me on Instagram https://www.instagram.com/lisagumieniukcoach/

Connected with me on Facebook https://www.facebook.com/lisagumieniukcoach

Connected with me on Linkedin https://www.linkedin.com/in/lisa-gumieniuk/

Joined the With Lisa Facebook Group which is a space to connect with other practitioners and linked minded people https://www.facebook.com/groups/withlisa

Joined Chaos to Clarity Reset Facebook Group (Optional) https://www.facebook.com/groups/chaostoclarityreset

Required

THANK YOU

THANK YOU again for taking the time to read and respond to the podcast application.

I feel very honoured you have decided to join!

We are going to have fun and your message of Transforming Chaos to Clarity with a Reset is going to spread far and wide.

If you have any questions, please do not hesitate to contact me.

Sending love and wellbeing your way!
Lisa Gumieniuk

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

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