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MEDIA CREDENTIALS REQUEST
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EVENT:
FIRST NAME*:
LAST NAME*:
MEDIA AFFILIATION*:
MAILING ADDRESS:
ADDRESS LINE 2:
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ST:	ZIP/POSTAL CODE:
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SECONDARY PHONE (cell/home):
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* My primary role at this event is (choose only one):
WRITTEN MEDIA	BROADCAST MEDIA
Reporter Features Photographer (bring 200mm lens or larger)	Talent Producer Camera

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MEDIA CREDENTIALS REQUEST