Media Accreditation Form
(*) indicates mandatory fields

ATTENDING JOURNALIST INFO
Select an ID picture of yourself (*) (in JPG or GIF format. Max size less than 1 Mbytes)
Family name (*)
First name (*)
Press Card n°
Street Address (*)
State/province
Zip code (*)
City (*)
Country of residence (*)
Personal Telephone
Mobile phone (*)
Fax
Email (*)
If part of a crew just give us the total number of the crew and state your position Head of project should fill this part
Are you coming to the festival on assignment for a Press/Media Company?	Yes No
Specify the name(s) of the Press/Media that published your last works Media type (*) Press Radio TV Internet Other Specify the media type (*) Audience type (*) International National Regional
MEDIA COMPANY Name of Media Company (*) Media type (*) Press Radio TV Internet Other Specify the media type (*) Name of your editor-in-chief (*) Audience type (*) International National Regional Street Address (*) Zip code (*) State/province City (*) Country (*) Telephone (*) Fax Email (*) Website url
MEDIA TYPE REQUEST
Authorisation type (*)	Video Photo Music Other
Who would you like to interview? (artists, organisers, etc.)	Artists Organizers Others
Who would you like to film (artists, organisers, etc.)	Artists Organizers Others
Who would you like to record (artists, organisers, etc.)	Artists Organizers Others
Satellite feed needed if available? (*)	Yes No
Indicate if you have already a specific day and time slot
Please, give us a short description of your project (what you want to produce)