JSR Guest Registration Form

Please fill out the form below. Upon completion, you will be redirected to the scheduler page to book your slot on the show.

Basic Information

Name *

Phone *

Email Address *

Website

Upcoming Project(s) & Release Date(s)

Promotional Photos *

Drag and Drop (or) Choose Files

Please upload presentable photos to be used for promotion. Please consider uploading at least 3 photos. Avoid selfies and low quality images. 15 MB limit

Promotional Video *

Drag and Drop (or) Choose Files

Please upload presentable videos to be used for promotion. Avoid low quality video. If your video exceeds the maximum size limitations, please email us at podcast@jsrmedia.online and we will provide you a link to upload your larger video. 256MB Limit

Beverage Preference *No BeverageWaterSoft Drinks - Sprite, Ginger Ale, Coca Cola, etcJuiceWhiskeyVodkaTequilaWineGinRumChampagne

Industry Category *EntertainmentAdvertising & MarketingComputer & TechnologyAirline/AviationAgricultureConstructionEducation/E-learningEnergyFashionFinance & EconomicsFood & BeveragesHealthcareHospitalityManufacturingMediaMiningPharmaceuticalTelecommunicationLaw EnforcementLegal/LawAutomotiveCosmeticsGraphic DesignContent CreatorSportsPublic RelationsGovernmentMusicInvestmentsArmed ForcesReligionVisual ArtistNon-ProfitHair StylistContractorReal EstateHome ImprovementOtherSelect one or more categories that aligns with your current line of work, passion, etc.

Advertising/Vendor Information

Are you interested in Ad Packages or Sponsorship? *YesNo

Are you interested in becoming a vendor for future events hosted by JSR or affiliates? *YesNo

Media Release & Acknowledgement

Do we have permission to video/audio record you? *

Yes, I grant JSR and any of its affiliated companies permission to video and audio record me and use the material to promote the episode.

By clicking yes below, you acknowledge that you must be over the age of 21 with a valid ID. *

Yes, I am over the age of 21 and have a valid ID.

Signature *

Start signing your signature here

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