JOHN WALLACE


Guest Appearance Request Form


"Not Just Another Pretty Face in Politics!"

Please Fill out the following "Do-it-yourself" Booking Form for JOHN WALLACE to be a Guest on your Radio, TV Show or to speak before your group on the issues of the day.

When you are finished. click the Submit button. After we receive your request, we will contact you via email. If you have any additional questions/comments, please include them at the bottom of this form.
If you prefer to schedule by phone, please call: 518-392-7062.


Requested Interview or Appearance Date:
Interview Start Time - Hour and Minute: AM PM
Interview Ending Time - Hour and Minute: AM PM
Time Zone:
Program Name::
Station or Network:
Broadcast area (i.e. city, state, internet or national):
Who Calls Who? Guest to call host at Studio #:
Host to call guest (We will contact you with guest number if you selected this option.)
Your Main Switchboard Number:
Who do we notify or contact with your guest confirmation: Name of Contact:

Email of Contact:

Contact Tel #

Contact Fax#
Any Comments, Issues, Questions or Special Instructions you may have:





This document maintained by the Gray Rider.
Material Copyright © 2008