Guest Interview Request Form

1.Contact Person
First Name* M.I. Last Name*

Email Address* Daytime Phone* Evening Phone*
2.Cell Phone
3.Please enter the date you would like to appear on Good Morning Arklamiss.
Month* Day* Year*
4.Which interview time slot do you prefer?*
5:55 a.m.
6:15 a.m.
5.How many guests are participating in the interview?
6.What are their names and titles?
Name of guest 1*
Title of guest 1*
Name of guest 2
Title of guest 2
Name of guest 3
Title of guest 3
7.Would you like to include a performance as part of your segment? If yes, please describe.
8.If you are using music, please describe the form of music you are bringing with you (e.g. CD, sound system, instruments, etc).
9.If you are using music, do you have permission/performance rights for the music?*
Not Using Music
10.If you’re promoting an event, please fill in the following details:
Name of event*
Date of event*
Time of event*
Venue of event*
Cost of event*
Contact information*
More information*
11.Please list any phone numbers, email address or websites that you would like shown on the screen. Remember to submit a digital graphic or video link to use for the monitor behind you to
12.Is there any other information that you think is pertinent to this interview?
13.Please list three questions that you would like to be asked during your interview. Then provide a brief answer to each question (about three sentences).
Question 1*
Response 1*
Question 2*
Response 2*
Question 3*
Response 3*
14.Please enter your date of birth.
Month* Day* Year*

15.Terms and Conditions
I have read, understand, and agree to the Website usage agreement and privacy policy.
* represents required fields

We will contact you to discuss your interview request. Once date and time are confirmed, you will receive an email with pertinent information regarding your interview.

**The FCC requires KNOE to provide closed captioning to better serve the hearing impaired. All interview guests MUST provide text that will be used for closed captioning. Failure to provide this information will result in the cancellation of your interview.

Thank you for your interest in appearing on Good Morning ArkLaMiss.

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