Behind The Veil Podcast Application

Application Page

First Name *

Email *

Phone *

How Old Are You? *

What Is Your Occupation? *

Relationship Status (If Married How Long Have You Been Married? *

Can you describe a current challenge you're facing in your relationship? If you're single, what obstacles do you encounter in finding the right partner? *

What Kind Of Guidance Or Support Are You Seeking Through This Experience? *

Have You Sought Any Other Forms Of Help (Therapy Or Counseling) For Your Current Situation? *

What Do You Hope To Achieve Or Gain From Participating On This Podcast? *

Are You Comfortable Being Anonymous? *

Yes

No

If Selected, Are There Any Specific Topics Or Details You Prefer To Keep Private? *

Do You Consent To Having Your Audio Interview Recorded And Potentially Shared On The Podcast And Related Platforms Including Social Media And Website? *

Yes

No

Do You Understand That Your Participation Does Not Guarantee That The Episode Will Be Aired? *

Yes

No

Do You Understand That The Audio Recording Will Be Done On Zoom, However, Your Identity, Face, Or Background Will Not Be Revealed. You Will Remain Anonymous? *

Yes

No

Do You Have A Laptop To Record Our Interview On? *

Yes

No

Is There Anything Else You Would Like Us To Know About Your Story Or Situation? *

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