1.Name

2.Brief summary of what you would want to share on the Mental Health and Me Podcast?

3.What social medía platforms would you promote your episode on?

4.Would you prefer to record in person at the Key103 radio station or via Zoom?

Key103 Radio Station

Zoom Meeting

5.Do you understand that the podcast would be a dialogue between you and the host and that the final product may or may not be released at the discretion of the host?

Yes

No

6.Contact Info

Phone

Email