Media accreditation Form

To request accreditation for 2011 Monsoon Cup Media Centre, please complete all sections of the following form and press the submit button to send your details to the 2011 Monsoon Cup Media Centre Media Centre Administrator.

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* Fields are required.
Personal Details
First Name * 
Surname *
Job Description *
Telephone
Fax
Mobile
E-mail*
Confirm E-mail*
 
Contact Address
Address Line 1
Address Line 2
City
Postcode
Country*
   
Business Details  
Name of Publication *
(If freelance, please state titles/media you work for)
Company Name *
Company or Publication Website * http://
Publishers or Managers Name *
Publishers or Managers Email *
Circulation Period *
Circulation Amount(numeric only) *
   
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