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Mr Ms NAME:
FIRST NAME:
TITLE:

CATEGORY:

Trade press Economic/business press

Daily Press: Technology Correspondent Business Correspondent

TV station Radio station Press agency Photographer

Name of TV station:

For TV journalists, please indicate the name and title of accompanying staff (director, cameraman, technician, etc.), if any. Use additional sheets if required:

NAME:

FIRST NAME:

TITLE:

ADDRESS where documentation should be sent if different from above:

TELEPHONE: +_______________________________ FAX: +_______________________________
            (country code,area code,number)       (country code,area code,number)

I would like documentation in English / Spanish

I intend to cover the Exhibition the Forum

I intend to be at TELECOM on the following day(s)

9 June 10 June 11 June 12 June 13 June 14 June 15 June

DATE: _____________________ SIGNATURE:_____________________