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Media interview request

If you're interested in interviewing Erica Djossa, please enter the following information below to submit a request.
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Program Information

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Request
Details

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Promotion Details

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Name*
Phone*
Email*
Name Of Publication/Program*
Name Of Interviewer(s)*
Type of Media*
Who is Your Primary Audience?*
What Platforms Do You Plan To Share And Promote The Interview?*
Website*
Facebook Page
Twitter Profile
Instagram Profile
TikTok Profile
Propose 3 possible interview dates*
Anticipated Release of Interview*
Proposed Interview Topic*
Time Commitment for Erica*
preferred method for recording*
What are the deliverables from this opportunity?*
What is your promotion strategy?*
Are you willing to mention Momwell in your promotion?*

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Thank You!

Your request has been submitted. We will contact you about next steps if we decide to move forward with an interview.
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