AVON 39 Media Credentials Request Form

Media Credentials Request Form

Please complete the form in order to submit a request for media credential to cover an AVON 39 event. Credentials are intended for working media ONLY; complimentary event access will not provided to non-working media. Please complete the online form for each person requesting a credential.

*1.

Question - Required - Organization

*2.

Question - Required - Type of Media Radio
Print
TV
Other

*3.

Question - Required - Share one of your recent articles with us (bylined by applicant)

Please provide the information below:

Name:

Title	First Required	Last Required

Email: Required

Street 1: Required

Street 2: Required

City/State/ZIP:

City Required	State Required	ZIP Required

Phone Number: Required

Yes, I would like to receive e-mail from Avon Foundation

*5.

Question - Required - Which AVON 39 event are you requesting credentials for?

*6.

Question - Required - Please provide website for your publication.

(Maximum response 255 chars, approx. 5 rows of text)

*7.

Question - Required - Total number of credentials

*8.

Question - Required - Name of Attendees (please list names & titles)

*9.

Question - Required - Please provide any additional information related to your media credential request

Select City

Which city would you like to register for?

Santa Barbara

Sep 12-13, 2015

New York

Oct 17-18, 2015

Houston

Apr 23-24, 2016

Washington DC

April 30-May 1, 2016

Chicago

Jun 4-5, 2016

Boston

July 9-10, 2016

San Francisco

Jul 23-24, 2016

Login