Media Accreditation Form
Connect Africa Summit: 29-30 October 2007, Kigali, Rwanda
Please read the Media Accreditation Procedure before submitting this form!

* = Required Field

Contact Information:
Mr   Ms
* First Name:
* Last Name:
* Job Title:
  Country Area Number Extension 
* e-Mail:
I will cover the Summit on-site remotely
* Name of media organization (publication, Radio/TV station, News Wire service):
* Country of Parent Company:
Full address of media organization:
* Address:

PO Box:
* Postal Code:
* City:
State / Territory:
* Country:
Address where documentation should be sent, if different from above:

PO Box:
Postal Code:
State / Territory:

Preferred language for documentation English French

Media Category:

Daily Press

General Correspondent
Technology Correspondent
Business Correspondent
Trade press
Economic/Business press
Online publication
News Wire service
TV Station
Radio Station
Industry Analyst

I am accredited at the United Nations in: New York Nairobi Geneva Vienna

Data Privacy:
 These details will form part of the Media & Analyst List which is on-line and password-protected for the officially designated media representatives of our participants only. Please tick this box if you do not want your contact details to be made available.
 By default, accredited media are placed on the ITU media information mailing list. Please tick this box if you do not want to continue receiving ITU media information after the Event.
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