MEDIA ACCREDITATION FORM
Owen G Glenn FIH Champions Trophy (men’s)December 3-11, 2011 Auckland, New Zealand
1. Personal Data /
Photo
Last name:First Name:
Address:
ZIP & Country:
Phone:
Mobile phone:
Fax:
E-mail:
Date of birth: / Sex: / Nationality:
AIPS card number: / National press card number:
2. Type of media and Organization
This section must be filled out, in order to get an accreditation for the event.
In case of freelance & photographer, please indicate the media you will work for during this event.
q o
/ International Press Agency /q o
/ National Press Agency /q o
/ Daily Newspaper /q o
/ Internetq o
/ Weekly Newspaper /q o
/ Monthly Newspaper /q o
/ Hockey Magazine /q o
/ Photographer(tick another box too)
q o
/ TV Commentator /q o
/ Radio Commentator /q o
/ TV/Radio Technician /q o
/ Freelance(tick another box too)
Media name:
Address:
City & Country
Phone: / Fax:
Signature: …………………………………………………………………….
IMPORTANT MEDIA ACCREDITATION INFO
Owen G Glenn FIH Champions Trophy (men’s)
December 3-11, 2011 Auckland, New Zealand
· Journalists who would like to be accredited for FIH Champions Trophy (December 3-11, 2011) are kindly requested to complete the accreditation form in full.
· Only journalists with a valid AIPS card or an approved national press card will receive a media accreditation.
· Applying for an accreditation does not automatically give the respective journalist the right for a media accreditation. All persons who apply for an accreditation will receive a confirmation in case their accreditation is approved.
· All international journalists (non New Zealand/Australia) are requested to return their accreditation form to:
FIH Communications Department
E-mail:
Fax: +41 21 641 06 07
· All New Zealand and Australian journalists are requested to return their accreditation form to:
Julia King, Hockey NZ
Fax: +61 9 630 2954
· The organizing committee of the FIH Champions Trophy has selected the Ibis Hotel as the designated hotel for working media.
Address: 72-112 Greenlane Road East, ELLERSLIE 1543, AUCKLAND, NEW ZEALAND. Tel: (+64) 9 5299091 Fax.: (+64) 9 5299092
Single room or double room - (NZD) $115 including tax.
Breakfast additional $25 per person
· There will be dedicated media shuttles departing regularly from the Ibis Hotel.
· For information about Auckland visit: www.aucklandnz.com or if you’d like destination Auckland story ideas or images please contact Jo Mackie –
Please return this form to:
FIH Communications Department Fax: +41 21 641 06 07; e-mail:
DEADLINE: Friday, November 26, 2011