Accreditation form




     


 
 

*FAMILY NAME

*FIRST NAME

 

 
  *MR.     MS. UPLOAD PHOTO
 

FAMILY NAME

FIRST NAME

 

ACCOMPANIED BY

 
  MR.     MS. UPLOAD PHOTO

*ORGANISATION

*OFFICE AND TITLE IN YOUR ORGANISATION

PRESS: Please type: title of newspaper, other organization, other country
PRESSE: Prière d'écrire le titre du journal, autre organisme, autre pays

ADDRESS

TOWN

*COUNTRY

POST CODE

TEL.

FAX

*EMAIL

*PARTICIPANT

JURY MEMBER RADIO

MUSIC

DRAMA

DOCUMENTARY

JURY MEMBER TV

PERFORMING ARTS

DRAMA

CULTURAL/GENERAL INTEREST

JURY MEMBER WEB

JURY MEMBER SPECIAL PRIZES

DELEGATE

OBSERVER

ITALIAN PRESS

FOREIGN PRESS

OTHER MEETING DELEGATE

WHICH ONE?

*ARRIVAL DATE

*DEPARTURE DATE


CURRICULUM VITAE


NOTES

SIGNATURE