The PPAI Expo
Media Registration/Credentialing Form

We will only give out media badges to legitimate, verified media, which means the publication/media outlet can be confirmed and there is the real potential that media outlet will cover our industry and/or the event.

Also, only media can be credentialed (e.g. reporters, editors, etc.). Sales people, account executives and/or publishers will not be issued a media badge. We reserve the right to refuse media credentials to those not meeting our Media Credentials Policy.

*Select Event	PPAI Expo Promotions East
Prefix (Mr., Mrs., Ms., etc.)
*First Name	MI
*Last Name
Badge First Name
Badge Last Name
*Publication/Media Organization
*Title/Position
*Address
*City
*State
*Zip
*Daytime Phone
Fax Number
*Email Address
Website URL
Special Requests: (i.e., interview/mettings with specific individuals, etc.)
*Media Category	Consumer Newspaper Consumer Magazine Radio Television Trade Publication Internet/Online News Service Other (please specify):