Tell us about yourself

Thank you for your willingness to participate in a Community Catalysts podcast interview! Our goal is to share candid stories of the challenges and achievements that come with community leadership, inspiring and instructing those striving to make a difference in their own communities. This questionnaire should take no more than 10 minutes—your top-of-mind responses will help shape a meaningful and engaging conversation. Once you’ve completed it, I’ll be in touch to follow up personally. - Matt Lehrman

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* 1. Please tell us about yourself:

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* 2. What is your current (or recent) leadership role?

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* 3. Please tell us about the community or organization that your leadership serves.

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* 4. How do you self-identify (i.e., gender, age, race, religion, national origin, ethnicity, sexual orientation, or disability status)? This optional question helps us engage a diversity of guests but in our discussion it’ll be entirely up to you what you want to share.

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* 5. What's an early experience on your journey to leadership that deeply impacted you personally?

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* 6. What's a significant challenge, situation, or initiative you've faced that we could dive into deeply; allowing you to share hard-earned insights from which others might draw inspiration and/or instruction?

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* 7. What are 1 or 2 practical lessons that an audience of current and aspiring community leaders might take away from the experience you mentioned in #6?

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* 8. If possible, please share a leadership experience that specifically involves your collaborating beyond your jurisdiction (with colleagues in other localities) or within your locality (involving different levels of government)? What practical insight or lesson might a listener take from that experience?

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* 9. Reflect briefly on how your community is changing. What's a profound responsibility, challenge, or opportunity your community or organization will need to address within the next 5 to 10 years?

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* 10. Is there anything more that we should be sure to ask you about on the podcast?

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* 11. How may we connect with you on Social Media?

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* 12. GUEST RELEASE AND CONSENT:  By participating in the podcast, you (Guest) grant the Producer (Social Prosperity Partners) the right to record, use, publish, and/or distribute any audio or video interview or session, including Guest's name, likeness, biographical information, and any material derived from it. Guest waives any right to content approval and/or compensation arising from the use of recordings. Guest also releases and discharges the Producer from any liability arising from the podcast. Guest warrants that they have the right to enter into this agreement and will indemnify the Producer against any claims resulting from any breach of these warranties. This release is binding upon Guest and their heirs, personal representatives, agents, successors, and assigns. The Producer is not obligated to broadcast or publish the interview or session.

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