CBS Cares Questionnaire Form - CBS Lake Charles

CBS Cares

To better serve you and our viewers, we'd like to gather as much information as possible from you before your interview. Please give us as much information as possible, but it's okay to leave items blank...

Organization Name(Required)

Representative/Interviewee Name(Required)

First Last

We want to be sure your representative's name is spelled correctly on-screen.

In your own words, please give a brief description of your organization.(Required)

What do you do in the community, who do you help, how do you help, and how can others get involved or donate to help?

Organization Website

If your organization has a website, please list it here.

Organization Facebook Page

Example: facebook.com/yourorganizationname

Organization Contact Email

If applicable, where can our viewers email you?

Organization Phone

What's the phone number that our viewers can reach you?

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your organization's physical or mailing address (if applicable)

Organization Logo

Max. file size: 50 MB.

.AI or .PNG files preferred. PDF or JPEG also accepted.

Upcoming Event Description

If your organization has any upcoming events you'd like to discuss in your interview, please write a brief description here.

Event Date

Event Time