KHSU Ascertainment Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Air Date of Interview or Program: *

YYYY

Title of Show: *

Length of Interview (in minutes): *

Show Host Name: *

Guest Name(s): *

Topic of Interview or Program: *

Topic Category *

Enter your e-mail to receive a copy:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Cal Poly Humboldt.

Does this form look suspicious? Report