Welcome to City of High Point Form Center

2. 
4. Name*
5. Email Address*
7. Address
9. City
10. State
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
11. Zip Code
13. Work Number
14. Mobile Number*
16. What organization will you be representing?*
18. What is your title at your organization?
20. What is your organization's website?*
22. What would you like to be the topic of your podcast experience?*
24. You can have up to one guest with you on the podcast. Will you have a guest?*

    1. Yes
    2. No
26. If yes, what is your guests name?
28. What is your guests email?
30. Where did you hear about us?
    -- Select One --Social MediaItunes Buzz SproutWebsiteHPTVSome random person you passed on the sidewalkOther
32. Are you able to record Monday - Friday between 8 a.m. - 5 p.m?

    1. Yes
    2. No
    3. Can we talk about nights and weekends?
34. What is the timeframe you can record your podcast with us?
    -- Select One --2 weeks from submission of this form1-6 months of submission of this form1 year from submission of this form
36. Do you agree that your information is relevant and important to help the City be an awesome place?

    1. Yes
    2. No
    3. I think it's not all great but important to let people know!
38. You are aware that you are doing this out of the goodness of your heart and will not be paid or compensated for your guest appearance, other than a high five?

    1. Of course, I love high fives and want to volunteer!
    2. Negative, I would rather take my talents to South Beach!

40. That's My Point!
    HighPointNC.gov/ThatsmyPoint
    Pio@HighPointNC.gov
    336.883.3288

41. 
42. 
Leave This Blank:


44. Submit

* indicates a required field