Thank you for your interest in Elephant Talk!
Fill out our brief questionnaire to be considered for the show.
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Please provide your first and last names.
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Both partners need to be willing to be interviewed for the podcast. Please discuss and confirm you are both wanting and willing to participate. *

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In what city and state do you live? *

Why do you want to participate in this recorded conversation? What might be an outcome of it? *

Is there a particular topic or issue you would like to discuss during the recording?

Thank you for your interest in Elephant Talk! We are excited to hear from you.
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