media accreditation request

MEDIA ACCREDITATION REQUEST
 Compilare il modulo direttamente sul PC o stamparlo ed
inviarlo al comitato organizzatore via mail (scansione) o fax.
 Das Formular direkt am PC ausfüllen, drucken & mit Fax oder
mail an das Organisationskomitee senden.
 Fill in the form directly on your PC, print it & send it by faxmail to the organizing committee.
Deadline: 30.06.2016
[email protected]
PERSÖNLICHE DATEN | DATI PERSONALI | PERSONAL DETAILS
Vorname|Nome|Name
Nachname|Cognome|Surname
__________________________
_____________________________
E-Mail ____________________________________________________
Telephone _________________ Nation_____________Sex|Sesso ____
Journalistenausweis-Nr.|Nr. tessera giornalistica|No. Press ID card ________________________________________
Ausgestellt von|rilasciata da|issued by _______________________________________________________________
Funktion|Funzione|Funktion
Journalist|Giornalista|Journalist ___ Freelance___ Fotograf|Fotografo|Photographer ___ Techniker|Tecnico|Technician ___
Medienart|Tipo di media|Type of media
Agency|Agenzia ___
Print ___ Radio ___ TV ___ Internet ___
Daten der Redaktion|Dati della redazione|Details of editorial office
Name|Nome|Name _____________________________________________________________________________
Adresse|Indirizzo|Address ________________________________________________________________________
Telephone _______________________________ E-Mail___ _____________________________________________
Anmerkungen |Note|Comments ___________________________________________________________________
 Ich erkläre, die Datenschutzbestimmungen zur gelesen zu haben und akzeptiere diese hiermit.
 Dichiaro essere a conoscenza delle direttive sulla privacy e firmando questo modulo accetto le stesse.
 I declare that I have read and I agree to the privacy data protection rules.
_____________ Datum|Data|Date
___________________________ Unterschrift Stempel|Firma & timbro| Signature & stamp
INFORMATION Die Akkreditierungsanfrage wird ausschließlich bearbeitet, wenn das Formular mit Stempel der Redaktion versehen
ist und eine Kopie des Journalisten-Ausweises beiliegt. Von Freelancern benötigen wir zudem einen Redaktionsauftrag.
INFORMAZIONI Saranno elaborate solo le richieste di accreditamento inoltrate su moduli complete di timbro della redazione e
corredati di copia della tessera giornalistica. Freelancers inoltre devono presentare un incarico scritto della redazione.
INFORMATION Accreditation requests will only be processed if the from encloses the stamp of the editorial office and a copy of the
press ID card. Freelancers must also include a written assignment by the editorial office.