First and Last Name

Email Address

Phone

Mailing Address

1. What role has accountability played in your life and success? (We believe accountability is the difference between hoping and doing.)

2. What does “Becoming Bossminded” mean to you personally? (We’re all about taking ownership—tell us what that looks like for you.)

3. When have you experienced a “Loving Kick in the Pants” that helped you grow? (Tell us a moment where tough love or self-awareness moved the needle in your journey.)

4. What’s your next big goal in life or business—and why does it matter to you? (We love future-focused guests with something bold on the horizon.)

5. Tell us about your business and how long you’ve been running it. (Give us a snapshot of what you do, who you serve, and how you help.)

6. Who is your ideal client, and how do you typically reach them? (This helps us align our message with your audience too.)

7. What offers or services are you currently selling, and at what price points? (We want to know how you're showing up in the market—and how established your offers are.)

8. What is your current annual revenue range? (Select one)

9. How large is your ENGAGED audience across email and social platforms? (Include approximate numbers and platforms.)

10. Have you been a guest on a podcast before? (If yes, feel free to drop a link or two!)

11. Will you commit to sharing your episode in at least 2 different places once it airs? (We only bring on guests who are active and excited to promote the episode.)

12. Which 3 episodes of Your Loving Kick in the Pants have you listened to, and what stood out to you? (Familiarity with the vibe and tone of the show is required.)

Short bio of who you are and what you do (70 words or less).

What is your website or specific link you'd like listeners to follow?

If you have an existing podcast please share a link below.

Have you submitted a professional headshot to bossminded@memberpages.app yet?

Yes I have.

I, [person applying], hereby agree to participate as a guest on the podcast Your Loving Kick in the Pants, produced by Bossminded, and agree to the following: I grant Bossminded and its affiliates the irrevocable right and permission to use my name, voice, image, likeness, and/or any statements made by me in any and all media formats—past, present, or future. This includes, but is not limited to, audio recordings, photographs, videos, and written content, in connection with the production, promotion, and distribution of the podcast. I understand that Bossminded will be the sole owner of all copyrights and other proprietary rights related to the podcast and its content. I waive any rights of ownership, compensation, royalties, or approval of materials or their usage. I release Bossminded and its officers, directors, employees, agents, and representatives from any and all claims, demands, or causes of action in connection with my participation in the podcast or use of the above materials. I confirm that I have read and understand this release and am signing voluntarily and without duress. This release shall be binding upon me and my heirs, executors, administrators, and assigns. By submitting this application, I agree to the above terms.

Please type your full name to serve as your electronic signature: (text field)

1. Do you acknowledge that your episode may not make it into the final lineup for the season, depending on the direction and quality standards of the show? (single choice – Yes required to proceed)

2. Do you acknowledge that the podcast interview will be held over Zoom, and that you are responsible for having quality lighting, audio, and a clean, non-distracting background? (single choice – Yes required to proceed) We want to ensure a professional, watchable experience for video and audio listeners alike.