Media Accreditation Form

To request accreditation for 2008 Meridien Marinas Airlie Beach Race Week, please complete all sections of the following form and press the submit button to send your details to the 2008 Meridien Marinas Airlie Beach Race Week Media Centre Administrator.

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* Fields are required.
Personal Details
First Name * 
Surname *
Telephone
Fax
Mobile
E-mail*
Confirm E-mail*
 
Contact Address
Address Line 1
Address Line 2
City
Postcode
Country*
   
Business Details  
Publication Title **
(If freelance, please state titles/media you work for)
Company Name
Company Website http://
   
Office Address  
Address line 1
Address line 2
Postcode
Country
Telephone
   
Media Details  
Media Type *
Media Category *
Media Frequency
Do you want to receive daily news releases by email during the event?
  Yes No
OR if you wish to receive daily news by fax, provide number:
Fax Number :