Podcast TAGQ Speaker Form

Please complete form below. Technology Requirements: Full details and instructions will be included in the Episode Brief once the recording date is scheduled. The episode recording will take place over Cleanfeed.net. Please note that Cleanfeed works best on the Google Chrome browser on a desktop. Wired earbuds or a mic & closed-ear headphones are recommended. We will want to do a 5-minute tech check the day prior to the recording. A CFW team member will reach out to schedule.

Speaker Name*
First Last
Short Title*
Organization*
Organization Preferred Twitter Handle*

Pleaser provide 3 dates/times you are available to dedicate a maximum of 60 minutes to record this session prior to April 30, 2022.*

To enter additional date options, click on the (+) sign to the right.

In order of preference, please indicate your top three categories based on the list below:*
Option 1
Option 2
Option 2
Option 3
Option 3
Email*
Assistant Email
CC Email
Phone*
Short Bio*
Please provide a short bio of up to 100 words
Headshot*
Please upload your current headshot to be used on our website, program
Max. file size: 20 MB.
Name
This field is for validation purposes and should be left unchanged.