Credential Resquest Form (open)

Media Affiliation/Organization: *

Name of Editor/Director: *

Email address *

Address: *

City: *

Province / State: *

Country: *

Postal / Zip Code: *

Phone: *

Fax: *

Website: *

Description of your publication – newspaper – magazine – video – TV show – website: *

*Freelancer: please indicate the name(s) of the magazine(s) or website(s) you will be working for during the event.

Please check the category(s) that apply to your organization: *

Autres (S.V.P. spécifier):

Total Circulation of your media: *

Is your reach for publication: *

Régional?
National?
International?

Credential #1: Name *

Credential #1: Title *

Credential #1: Email *

Credential #1: Cellphone *

Credential #1: Arrival date *

Credential #2: Name *

Credential #2: Title *

Credential #2: Email *

Credential #2: Cellphone *

Credential #2: Arrival date *

Credential #3: Name *

Credential #3: Title *

Comment - mandatory if "no"

Credential #3: Email *

Credential #3: Cellphone *

Credential #3: Arrival date *

Please check your special needs for the press room: *

Continuous access to a modem line ($)
Partial access to a modem line
Partial access to a computer with Internet access
Access to a printer
Telephone
Fax
Other:

Interview *

If you want to INTERVIEW an athlete, please indicate his/her name and the date/time you would like to do the interview:

Will you mail us a copy of all work containing reference to this event? *

Please mail to: Gestev Inc. Att: Josée Lapierre 1000, boul. Beau-Pré, bureau 7106 Beaupré, Québec, Canada G0A 1E0

Please let us know when we should expect copy of your work (month). If Website, please indicate the complete address.

Vélirium 2008

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Preliminary schedule