Interview Request and Consent Form :: What Should I Be

What Should I Be is a worldwide educational project.

The "What Should I Be" project (free to the public), presents a series of audio interviews (from people working in all types of exciting careers worldwide) and delivers them via the web through iTunes (accessible by smart phones, tablets/iPads and computers) as well as directly from the “What Should I Be” (http://www.WhatShouldIBe.me) website.

The project is dedicated to helping young people (typically in their teens) who are trying to figure out "what they should be and do with their lives" as they consider life after High School, such as continuing on to College (and for what), attend a Trade School, etc.

We appreciate your interest and willingness to participate.

Sincerely,
Gary M. Gordon
Founder and CEO of What Should I Be

All parties, noted herein, by completing this form, fully understand and agree that the interview being provided by the Interviewee will be owned and considered the sole property of WPBNS (and or the What Should I Be, Inc. project) and that no compensation will be provided to the Interviewee or any other parties. All parties also agree that WPBNS and/or the What Should I Be project may use the interview, as well as any other provided materials (such as text, imagery, etc., as well as any text, imagery, audio, video, etc. from any website, blog, etc. that is provided to WPBNS) in any manner deemed appropriate and useful as well as for any marketing or other purposes deemed necessary and appropriate by WPBNS and/or the What Should I Be, Inc. project. This Interviewee is providing the interview, and all other materials, as a donation to WPBNS and the What Should I Be project.

No other or additional oral or written agreements or promises have been made beyond what is stated above.

By completing this form, all parties agree that this is the complete agreement and that no other or additional oral or written agreements or promises have been made beyond what is stated herein.

How were you referred to us? *

For example, were you referred to us by a Person, a School or University, a TED Talk, by searching on Google, Yahoo or Bing, a Website, etc. How did you find us?

Name of Interviewee *

First

Last *

Last

Country *

State *

Primary Email of Interviewee *

Primary Contact Phone Number of Interviewee *

Website of Interviewee (if applicable)

Age (of Interviewee) *

Do you have a SKYPE account? (THE USE OF SKYPE IS TYPICALLY REQUIRED FOR MOST INTERVIEWS) *

Yes

A Skype account is not required. But it often provides a clearer audio recording for Interviews and is preferred if possible.

What is your SKYPE username? *

Tell us which of the following applies to you, regarding your SKYPE account. (Select one or more from the choices.) *

I have a webcam (with a built in microphone) that I can use with Skype, for the Interview.

I have a separate and good quality microphone that I can use with Skype, for the Interview.

I have a headset with a built in microphone that I can use with Skype, for the Interview.

I DO NOT have any webcam or microphone of any kind available to be used with Skype.

I am very familiar with how to use Skype.

I am somewhat familiar with how to use Skype.

I am NOT familiar with how to use Skype and would need help.

Even though I have a Skype account, I would prefer to use the telephone (a Land Line Phone) for the Interview.

SELECT ONE OR MORE FROM THE ABOVE CHOICES - AS APPROPRIATE.

Would you be willing to setup and create a 'FREE' SKYPE account to be used for your interview? (RECOMMENDED) *

Yes

IMPORTANT NOTE: BY INSTALLING AND USING SKYPE, THIS WILL HELP BY PROVIDING A MUCH HIGHER QUALITY RECORDING AND INTERVIEW, INSTEAD OF TALKING OVER A PHONE LINE. (This will require installing SKYPE, which is a FREE program for use on a PC and/or MAC.)

Do you have a WebCam (or an external microphone) as well as Speakers connected to your computer? *

Yes, I have a WebCam (for video and audio) and Speakers and I can confirm that they 'both' work properly.

Yes, I have a WebCam (for video and audio) and Speakers, but I am not sure if they work. (I don't typically use them.)

No, I do not have a WebCam (for video and audio) and/or Speakers.

No, I do not have a WebCam (for video and audio) and/or Speakers at this time, but I would be willing to obtain these items and have them set up so they are working properly, prior to the interview.

Your Career or Field Type (Note: If not found, select OTHER)
Select the most appropriate Career or Field of Work from the list provided below: *

OTHER (please specify your Career or Field Type if it was not listed in the previous list) *

Brief Title and Description of the Interviewee's Career or Field (In 10 words or less, what is it that you do?) *

Detailed Description of the Interviewee's Career or Field of work (In 500 words or less, tell us in detail - what it is that you do?) *

NOTE: This information will likely be used as part of the website listing for your interview. So, please include any details that you believe will be relevant.

Biography (Include a comprehensive and detailed biography. This can be provided in a bulleted list format or paragraph style - including dates.) *

A primary (casual or professional) photo of yourself for your listing. *

Maximum file size: 2.1MB

You can either upload a photo, or provide a URL (website address) to where we can find one or more photos that we can choose from to use as part of your interview listing. (To provide a URL to your photos - that we can use, add this information to the comment or question area below.)

INTERVIEWEE: How long have you been involved in your current career or field? *

Any Additional Comments or Questions:

NOTE: This information will likely be used as part of the website listing for your interview. So, please include any details that you believe will be relevant.