Credential #1

Name: ■

Title: ■

Email: ■

Cell Phone: ■

Twitter:

Arrival Date: ■

Departure date: ■

Credential #2

Name:

Title:

Email:

Cell Phone:

Twitter:

Arrival Date:

Departure date:

Credential #3

Name:

Title:

Email:

Cell Phone:

Twitter:

Arrival Date:

Departure date:

Media Coverage

Gross circulation of your media: ■

Will it be possible to send us of some of your work done during the event? ■

Please mail to: Corporation Coupe du Monde de vélo de montagne Mont-Sainte-Anne c/o Press Room 1000, boul. Beau-Pré, #7106 Beaupré, QC, Canada G0A 1E0

Yes
No

Potential media coverage:

Pre-event

Direct

Post-event