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Interview Request Form

To schedule an interview with Charles Hawkins for your talk show please fill out the online request form below. Within 24 hour you will be notify if your requested interview time is available, if not we will provide you with alternative dates.

Your Station Contact Information:

Contact Name

Title

Station Name

Phone Number

FAX

E-mail

City and State

Country

Talk Show Host Information:

Host Name

Name Of Show

Radio or TV Program

Coverage Area

Estimate Listener Base

Please provided a guest call in information:

Will Host Be Calling Charles Hawkins

Station Main Number

Back-up Number Mr. Hawkins Should Call

Requested Interview Date:

-- mm/dd/yy

Requested Interview Start time (Central Time):

-- hh:mm:ss am/pm

Time Interview will end (Central Time):

-- hh:mm:ss am/pm

Is there any additional information you'll need before the show:

Please note, if your interview has been accepted you will be notified within 24 hour via the email address you have provided.