NAIA MediaCredentialRequests

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					                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                               2012 Avista-NAIA World Series
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 Avista-NAIA World Series in Lewiston, Idaho, May 25 – June 1. All
working media will be required to possess an NAIA-issued media credential. Media credentials are for working media
only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age of 16
are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Alan Grosbach (agrosbach@naia.org) by Tuesday, May 22 at 5 p.m. CDT. All requests must be submitted via
email agrosbach@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 1
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                        2012 Buffalo Funds-NAIA Division I Men’s Basketball
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 Buffalo Funds-NAIA Division I Men’s Basketball National
Championship, March 14 – 20. All working media will be required to possess an NAIA-issued media credential to gain access to
restricted areas of Municipal Auditorium. Media credentials are for working media only. Individuals under the age of 16 are not
eligible for media credentials. Working media is defined as print/publication (with a circulation base), radio, or television.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to the NAIA National Office by THURSDAY, MARCH 8 at 5 p.m. CST. Please email your credential request to
cwaller@naia.org or fax to 816-595-8200 attention Chad Waller.
On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                    City, State, Zip:

Cell:                              Office:                                  Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Media credentials can be picked up at the information table located inside the main lobby at Municipal
Auditorium just before you enter the arena. Photo identification/media identification is required when picking up the
credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.

E-mail this completed form to cwaller@naia.org or fax to 816.595.8200 attention Chad Waller.

Name:                                            Signature:                                                Date:


NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 2
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                    2012 NAIA Division I Women’s Basketball
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Division I Women’s Basketball National Championship in
Frankfort, Ky., March 14 – 20. All working media will be required to possess an NAIA-issued media credential. Media
credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or
television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Alan Grosbach (agrosbach@naia.org) by Friday, March 9 at 5 p.m. CST. All requests must be submitted via
email agrosbach@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate
interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 3
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                       2012 NAIA Division II Men’s Basketball
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for 2012 NAIA Division II Men’s Basketball National Championship from March
7 – 13. All working media will be required to possess an NAIA-issued media credential to gain access to restricted areas of
Keeter Gymnasium. Media credentials are for working media only. Individuals under the age of 16 are not eligible for media
credentials. Working media is defined as print/publication (with a circulation base), radio, or television.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to the NAIA National Office by THURSDAY, MARCH 1. Please email your credential request to cwaller@naia.org
or fax to 816-595-8200 attention Chad Waller.
On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                    City, State, Zip:

Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate
interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:


NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 4
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                        2012 State Farm-NAIA Division II Women’s Basketball
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Division II Women’s Basketball National Championship in
Sioux City, Iowa, March 7 – 13. All working media will be required to possess an NAIA-issued media credential. Media
credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or
television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Jake Knabel (jknabel@naia.org) by Friday, March 2 at 5 p.m. CST. All requests must be submitted via email
jknabel@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate
interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 5
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                               2011 NAIA Men’s and Women’s Cross Country
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2011 NAIA Men’s and Women’s Cross Country National Championships
on Nov. 19 in Vancouver, Wash. All working media will be required to possess an NAIA-issued media credential. Media
credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or
television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Alan Grosbach (agrosbach@naia.org) by Nov. 16 at 5 p.m. CST. All requests must be submitted via email
agrosbach@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 6
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                 2011 Russell Athletic-NAIA Football National Championship

                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2011 Russell Athletic-NAIA Football National Championship on Dec. 17
from Rome, Ga. All working media will be required to possess an NAIA-issued media credential to gain access to restricted
areas. Media credentials are for working media only. Individuals under the age of 16 are not eligible for media credentials.
Working media is defined as print/publication (with a circulation base), radio, or television.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. On-site
credentialing is not guaranteed.
Please return this form to:
Matt Green (mgreen@shorter.edu) by TUESDAY, December 13 by 5 p.m. (CST).

PLEASE FILL OUT THIS FORM COMPLETELY (Type or Print)
* Required fields (State that an item is not applicable with “N/A”)

*School that outlet will cover:

*Media Outlet Name:                                                      *Contact Person:

*Media Outlet Type: (newspaper, radio, TV, etc.)

*Address:                                                                     *City, State, Zip:

*Phone:                                  Cell:                               *Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those that are photographers/videographers/bloggers by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential and ejection from the venue. Photo identification/media
identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate
interest in acquiring rights, please fill in the following:

          *Type of Rights (check one):
           Radio     Television    Internet Cybercast                    Web-blogging

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


E-mail this completed form to mgreen@shorter.edu

Name:                                            Date:


NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 7
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                        2012 NAIA Men’s Golf
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Men’s Golf National Championships in Salem, Ore., May 22
– 25. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working
media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age
of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Jake Knabel (jknabel@naia.org) by Friday, May 18 at 5 p.m. CDT. All requests must be submitted via email
jknabel@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 8
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                    2012 NAIA Women’s Golf
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Women’s Golf National Championships in Greeneville,
Tenn., May 15 – 18. All working media will be required to possess an NAIA-issued media credential. Media credentials
are for working media only. Working media is defined as print/publication (with a circulation base), radio or television.
Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Alan Grosbach (agrosbach@naia.org) by Friday, May 11 at 5 p.m. CDT. All requests must be submitted via email
agrosbach@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Media credentials can be picked up in the media workroom located in the club house. Photo identification/media
identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                2011-12 Media Credential Applications / page 9
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                     2011 NAIA Men’s Soccer
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2011 NAIA Men’s Soccer National Championship in Orange Beach,
Ala., Nov. 28 – Dec. 3. All working media will be required to possess an NAIA-issued media credential. Media credentials
are for working media only. Working media is defined as print/publication (with a circulation base), radio or television.
Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Chad Waller (cwaller@naia.org) by Nov. 23 at 12 p.m. CST. All requests must be submitted via email
cwaller@naia.org. On-site credentialing is not guaranteed.

PLEASE FILL OUT THIS FORM COMPLETELY (Type or Print)
* Required fields (State that an item is not applicable with “N/A”)

*School that outlet will cover:

*Media Outlet Name:                                                      *Contact Person:

*Media Outlet Type: (newspaper, radio, TV, etc.)

*Address:                                                                     *City, State, Zip:

*Phone:                                  Cell:                               *Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential and ejection from the venue. Credentials may be picked
up at Orange Beach Sportsplex once the tournament has begun. Photo identification/media identification is required
when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:



NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org               2011-12 Media Credential Applications / page 10
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                 2011 NAIA Women’s Soccer
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2011 NAIA Women’s Soccer National Championship in Decatur, Ala.,
Nov. 28 – Dec. 3. All working media will be required to possess an NAIA-issued media credential. Media credentials are
for working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals
under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Alan Grosbach (agrosbach@naia.org) by Nov. 22 at 12 p.m. CST. All requests must be submitted via email
agrosbach@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org               2011-12 Media Credential Applications / page 11
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                           2012 NAIA Softball
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Softball National Championship in Gulf Shores, Ala., May 17
– 23. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working
media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age
of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Chad Waller (cwaller@naia.org) by May 11 at 5 p.m. CDT. All requests must be submitted via email
cwaller@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                    City, State, Zip:


Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Media credentials can be picked up in the Gulf Shores Sportsplex press box on the day(s) of the National
Championship. Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org               2011-12 Media Credential Applications / page 12
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                       2012 NAIA Men’s and Women’s Tennis
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Men’s and Women’s Tennis National Championships in
Mobile, Ala., May 15 – 19. All working media will be required to possess an NAIA-issued media credential. Media
credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or
television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Jake Knabel (jknabel@naia.org) by Tuesday, May 8 at 5 p.m. CST. All requests must be submitted via email
jknabel@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org               2011-12 Media Credential Applications / page 13
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                         2011 NAIA Volleyball
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2011 NAIA Volleyball National Championship in Sioux City, Iowa, Nov.
29 – Dec. 3. All working media will be required to possess an NAIA-issued media credential. Media credentials are for
working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under
the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Jake Knabel (jknabel@naia.org) by Nov. 23 at 12 p.m. CST. All requests must be submitted via email
jknabel@naia.org. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Radio         Writer    Blogger         SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Media credentials can be picked up in the press box. Photo identification/media identification is required when
picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org               2011-12 Media Credential Applications / page 14
                                                                                               NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS




                                                         2012 NAIA Wrestling
                                          MEDIA CREDENTIAL APPLICATION
Please use this form to request media credentials for the 2012 NAIA Wrestling National Championship in Des Moines, Iowa,
March 1 – 3. All working media will be required to possess an NAIA-issued media credential. Media credentials are for
working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under
the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being
denied credentials for the event. The NAIA reserves the right to refuse media credential requests for any reason. This form must
be returned to Media Coordinator Amanda Dahl (amanda.c.dahl@gmail.com) by Monday, Feb. 27 at 5 p.m. CST. All requests
must be submitted via email amanda.c.dahl@gmail.com. On-site credentialing is not guaranteed.

School:                                                                 Name (if signing up as SID):

Media Outlet Name:                                                  Media Contact Person:

Media Outlet Type: (newspaper, radio, TV, etc.)

Address:                                                                     City, State, Zip:



Cell:                                Office:                                Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:
Please designate those by checking the appropriate column.

Name                                                       Photo        Video       Writer         Blogger        SID




Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable
and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal
trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo
identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a
live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest
in acquiring rights, please fill in the following:

Type of Rights (check one): Radio   Television
Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click here for Broadcast Rights Fees.


Name:                                            Signature:                                                Date:




NAIA National Office • 1200 Grand Blvd., Kansas City, MO 64106 • 816.595.8000 • www.NAIA.org                 2011-12 Media Credential Applications / page 15

				
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