Accreditation form

With the object of covering exhibition and participating in a press conference please fill in the electronic form of request for mass media not late than October 1^st 2008.

It will help you to get badge on registration area and informative materials in the press-center during the Pubic Health 2008.

Please complete the relevant details.

Name of MASS MEDIA*:
Last Name*:
Job Title:
Phone*:
Fax:
E-Mail*:
Address:
	Enter symbols which you see on a picture on the left
	* — indicates required fields