Transcript Media accreditation FINA MEN`S WATER POLO WORLD LEAGUE

www.fina.org
www.federnuoto.it
Media accreditation
FINA MEN'S WATER POLO WORLD LEAGUE EUROPE PRELIMINARY
ITALY - GEORGIA 10th January 2017 - BUSTO ARSIZIO
Mr
Mrs
Name
Surname
Country
Date of birth
Private address
Tel. n.
Fax n.
Mobile
e-mail
Media
Daily Newspaper
Press Agency
Magazine
Internet Website
Radio
TV
Photo Agency
Freelance
Journalist
Photographer
TV Commentator
Radio Commentator
Technician
Other
Name of the company
Business address
Function
Professional card
AIPS number
(type & number)
(If applicable)
Need the press center
yes
no
The Press Center will be equipped with wireless connection
I agree to the treatment of my personal details above provided, with reference to the Italian DLG No. 196/2003.
Date_____________________
Signature________________________
Please, send this form by mail to: [email protected] - [email protected]
Deadline 5th January 2017
Press Office:
Italian Swimming Federation tel. +39 06 36200444-3-2 e-mail: [email protected]
Sport Management - tel. +393453733259 / e-mail [email protected]