Media Credentials Form printable pdf download

GENERAL ASSEMBLY OF

THE U.S. CONFERENCE OF CATHOLIC BISHOPS

November 14-17, 2016

APPLICATION FOR NEWS MEDIA CREDENTIALS

NOTE: This form must be signed by editor or station manager.

Name of Applicant: ___________________________________________________________________

Name of News organization: ____________________________________________________________

Title: _______________________________________________________________________________

Office Address: _______________________________________________________________________

_______________________________________________________________________

Telephone:__________________________________Fax:____________________________________

E-mail:_____________________________________Twitter Handle:____________________________

Frequency of Publications/Airing: ________________________________________________________

Circulation/Distribution: ________________________________________________________________

Are you covering this meeting for the above named organization? Yes  No  If no, for what news organization are you

covering this meeting: __________________________________________________________________

Please indicate the news media directory – and the page number – where your publication, broadcast station, etc., is listed:

 Broadcast Yearbook (page _____)

 Directory of the Catholic Press Association (page _____)

 Editor & Publisher Yearbook (page _____)

 Directory of Unda-USA (page _____)

 Gale Directory of Publications and Broadcast Media (page _____)

Note to Applicants: Media covering the Bishops’ meetings should be aware that there is a system in place for requesting

interviews with a bishop. It involves submitting the request through staff of the Public Affairs office stationed outside the meeting

room door. Please do not approach the Bishops during coffee breaks, since many Bishops often use this time for committee

business. There will be locations available for interviews. All credentialed media are required to abide by regulations of the hotel

or risk losing their credentials. Also please note that tables in the press room are only for those materials originating from the

Bishops’ Conference. Any other materials that are placed there will be removed.

Upon registration, please be prepared to present a press card.

Please return this form no later than November 4, 2016.

November Meeting Credentials

Office of Public Affairs

3211 4th Street, NE

Washington, DC 20017-1194

TELEPHONE: 202-541-3200

FAX:

202-541-3173

_______________________________________________

Signature of Editor or Station Manager (required)

Media Credentials Form