AIR or TRAIN TICKET ORDER - DOC - DOC

							JOURNALIST ACCREDITATION                                                                                   WT-17
Journalist accreditation form to be sent to the promoter                 FIVB Beach Volleyball Swatch World Tour 2011

 Event Venue:                                                                             Event Date:

 1. Personal data

 Family name:                                                        First name:
 Address:
 City:
 ZIP Code:                                                           Country:
 Phone (home):                                                       Fax (home):
 Phone (office):                                                     Fax (office):
 Mobile phone:                                                       Email:
 Sex:                         F:              M:                     Nationality:

 National press card no:
 Issued: day / month / year        .      .                 In:

 AIPS card no: (if any)
 Issued: day / month / year        .      .                 In:

 2. Type of media
     International press agency                                   National press agency
     Daily newspaper                                              Daily sports newspaper
     Weekly/monthly newspaper                                     Online website(s)
     Volleyball magazine                                          TV commentator
     Radio commentator                                            Photographer (tick another box too)
     TV/Radio technician                                          Freelance

 3. Organisation
 Name:
 Name of the Sports Editor:
 Address:
 City:                                                               ZIP Code:
 Country:
 Phone:                                                              Fax:
 Organisation’s email:
 Sports Editor’s email:

 Place and Date:

 Signature:                                                                     X
                              Name                                            Signature



2011-02-15                             FIVB Beach Volleyball Swatch World Tour 2011                            Page 1