Full name *

Your title (as you’d like it to appear on screen) *

Email *

Phone *

City or area you serve *

Business name *

Website

Facebook page link

Instagram page link

LinkedIn link

YouTube link

TikTok link

Other social link

How long have you been in business? *
Select oneLess than 1 year1–3 years4–10 yearsMore than 10 years

In two or three sentences, what does your business do and who does it serve? *

What were you doing career-wise before you started your business? *

What sparked the idea for your business, and what made you decide to go for it? *

What was your biggest challenge in the early years, and how did you get through it?

Is there a story you’d especially love to share on the show?

Are there any topics you’d prefer not to discuss?

After the episode, what would you like viewers to do? (visit your website, follow you, attend an event, etc.)

Are you able to travel to our studio in Indianapolis, Indiana?
Our address is 2804 E 55th Pl, Suite H, Indianapolis, Indiana 46220 *

YesNo

Preferred days and times to record

High-resolution headshot (JPG or PNG, up to 5MB)

Business logo (JPG, PNG, or SVG, up to 5MB)

I confirm that I own an independent business, and that it is not a network marketing / direct sales business.

You may tag me and my business when promoting the episode.

If selected as a guest, I agree that my episode, including video and audio, may be published on YouTube, podcast platforms, and INSPIREsmall.biz.