1. What is your Name?

2. Give a few sentences on who you are and what your expertise is:

3. What specific topics do you want to share with the world:

4. Why are you passionate about your topic?

5. Who is your right fit audience?

6. In addition to traditional media coverage, do you have an interest in creating your own platform, like a podcast? 

7. When are you hoping to become an Ambassador and start using media as powerful marketing? (Right now people are waitlisted but we are about to open a new round of Ambassadors entering the program.)

8. Can you include a website or links for us to check out? We'd like to see if you'd be a fit / have something that would be interesting to the media. (Also include media experience or share links if you have them.)

9. How can we best reach you? Include your contact information here.

10. How did you hear about us? / Is there anything else you'd like us to know?