Axiom Mission 4 (Ax-4) U.S./Lawful Permanent Resident/Green Card Holder Media Accreditation Form

Axiom Mission 4 (Ax-4) U.S./Lawful Permanent Resident/Green Card Holder Media Accreditation Form

Complete Your Information for Ax-4 Media Accreditation

All reporters must request media accreditation to be onsite at Kennedy Space Center in Florida. Please complete the form below. Media accreditation deadlines will be updated on www.axiomspace.com/Ax4mediaaccreditation.

More details on all media opportunities and surrounding activities will be made available closer to the launch. For questions, please email: media@axiomspace.com.

Yes, I am a U.S. Citizen

Yes, I am a Permanent Lawful Resident

Legal First Name*

Your name must be submitted as listed on I-9 document(s).

Legal Middle Name

(If Applicable) Your name must be submitted as listed on I-9 document(s).

Legal Last Name*

Your name must be submitted as listed on I-9 document(s).

Email*

Title or Position

Mobile Phone Number*

Phone

Permanent Home Address (City, State, Zip)*

Company Name*

Company Address*

(Include street address)

Company Country*

Media Type*

Select

Will you be setting up a remote camera?*

Remote cameras capture the rocket launch from a designated location.

Select or enter value

Send me a copy of my responses

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