Media Accreditation Application

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  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Name of Media Organization REQUIRED Please fill out this field. Please enter valid data.
  
  URL of Media Organization Please enter valid data.
  
  Media Type (Print, Radio, Television, Online or Other [please specify]) REQUIRED Please fill out this field. Please enter valid data.
  
  Position (photographer, writer, camera operator, correspondent, editor, etc.) REQUIRED Please fill out this field. Please enter valid data.
  
  Requested Coverage Dates REQUIRED Friday night, October 20 (6 pm to 10 pm) Saturday, October 21 (7 am through 10 pm) Sunday morning, October 22 (7 am through 12:30 pm) Please fill out this field.
  
  Your request for Media Accreditation will be considered by the Media subcommittee of the Congress. We will get back to you as soon as possible to let you know about the decision and about credentials.
  
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