Online News Media Registration Form

Required fields are indicated with a red asterisk, [*]
Fill out this form and click the Submit button below, or use a printer-friendly version of this form that can be mailed or faxed.

*Name: (to be printed on badge)
*Media Affiliation:
*Title: (e.g., reporter, producer, editor ...)
*Mailing Address:
*Work Phone: 
*Email Address:

Freelancers: Describe your eligibility per criteria and bring relevant proof to the meeting.

Member of NASW
Regional affiliate of NASW
Letter from recognized publication assigning you to cover this meeting
Evidence of bylined science story published in 2005 or 2006

Field Trip Registration:
I would like to participate in the field trip to MBARI on Sunday, 10 December. (For details, see Media Advisory 2.)

Press pre-registration deadline is Friday, 1 December 2006. Form must be received at AGU by that date for your badge to be available upon arrival, avoiding delay. You may also register on site.