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Encaptify Roundtable Series

Thank you for being a featured guest on an upcoming episode of Encaptify! Please complete the following form to provide us with important information needed to set up and market your episode.

Speaker Intake Form

Your Info

  • First name
  • Last name
  • Email
  • Phone number
  • Company name
  • Job title
  • Website URL
  • Short Bio (300 characters)
  • Headshot
  • LinkedIn Personal Page
  • LinkedIn company page
  • Facebook Personal Page
  • Facebook company page
  • Twitter Username (personal)
  • Twitter Username (company)
  • Instagram Username (personal)
  • Instagram Username (business)

Show Details

  • Appearance Date: Month/Day/Year
  • Appearance Time
  • Episode Title
  • Episode Description
  • Would you like to add a call to action (CTA) to your session?
    • Yes
    • No
  • Call to Action Text: Ex. Book a complimentary 30-minute discovery session to learn how you can unlock your potential.
  • CTA Button Text: Ex. "Buy Now", "Schedule", "Sign Up"
  • CTA URL: URL we should direct people to complete your call to action.
  • Would you like to add a poll to your session?
    • Yes
    • No
  • Poll Title: 1 to 3 words to help your audience easily identify the poll. i.e. "Favorite Color"
  • Poll Question: Ex. What is your favorite color?
  • Provide your poll responses (answers) below. We recommend:
    • Keep answers short and sweet (1 to 3 words) so audience members can quickly and easily answer.
    • At least 2 responses (i.e. yes, no)
    • No more than 5 responses
  • Poll Response 1
  • Poll Response 2
  • Poll Response 3
  • Poll Response 4
  • Poll Response 5

Special Offer

  • Would you like to provide a special offer for Encaptify guests?
    • Yes
    • No
  • Offer Title: Ex. Save 30% or Free Coaching Session
  • Offer Description (340 characters): Describe your offer in more detail, but try to keep it short and sweet.
  • Offer Button Text: i.e. "Claim Offer "or "Get Now"
  • Offer URL: URL we should direct people to claim your offer.

I hereby grant Encaptiv Corporation and Publio LLC, the holders of the Event, permission to record my voice and photograph me in conjunction with the Event. I understand and agree that the term "photograph" as used herein encompasses both still photographs and video recordings. I further grant Encaptiv Corporation and Publio LLC, the holders of the Event, full unrestricted rights to the use of my photograph, voice, and likeness in any form, including edited versions, in or over any medium including without limitation streaming audio and/or video over the internet, broadcast, cable, satellite transmissions, and media that are unknown at this time, worldwide for any purpose including without limitation any commercial purpose.