MEDIA ACCREDITATION FORM
Beneva Quebec City Marathon presented by Montellier
REQUESTER’S INFORMATION
First and last name :
*
Email :
*
Cell phone :
*
City, Province/State/Department, Country :
*
MEDIA INFORMATION
Media name :
*
Media website :
Media category :
*
Television
Radio
Agency (Press/Photography)
Internet
Daily/Weekly
Magazine
Other
Other
Position :
*
Journalist
Cameraman
Photographer
Videographer
Other
Position (other)
Date of coverage
*
Saturday October 5th
Sunday October 6th
Type of coverage :
*
News
Special report (specify below)
Documentary (specify below)
Video (specify below)
Type of coverage (other)
*
Additional comments :
Date
*
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Calendar
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