Annual Conference Media Credentials Submission Form

Annual Conference Media Credentials Submission

Name

First Middle Last Suffix

News Organization:

Title:

Media Story Assignment:

Please upload an assignment letter

Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

Link to bylined article within the last 6 months. (Reporters)

Link to an article that displays your photo credits. (Photojournalists)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone

Cell Phone

This field is for validation purposes and should be left unchanged.

Our organization is a 501(C)(3) and is recognized as the nation’s top African American led mentoring organization.

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