Media Accreditation Form

Thank you for your interest in the 2010 Playhouse Wine Festival. If you would like to be added to our media list, please complete the accreditation form below. All accredited media will receive a pass to all five tasting room sessions. Requests for specific events will be considered but are not guaranteed.

Please note that accreditation will be given to reporters, writers, editors, videographers, photographers, and producers. Advertising, sales and marketing, and administrative staff are not considered working media and will not be accredited.

*REQUIRED FIELDS

AFFILIATION / COMPANY INFORMATION

Affiliation / Company *^*

Address*^*

City*^*

Province / State

Postal / Zip Code*^*

Country

Main Phone*^*

Website

AFFILIATION CLASSIFICATION

Category* (ie. Newspaper, magazine, broadcast, website, blog, freelance, other)^*

Circulation* (Web contributors / editors please provide number of unique visits per week)^*

AFFILIATION CONTACT

First Name*^*

Last Name*^*

Title*^*

E-mail*^*

PLEASE LIST THE FESTIVAL EVENTS YOU WOULD LIKE TO ATTEND IN ORDER OF IMPORTANCE.