University of Miami
Coral Gables, FL 33146
Phone: 305-284-5500
CREDENTIAL REQUEST FORM FOR THE
GLOBAL BUSINESS FORUM
January 15 - 16, 2009
This form must be received by the media relations department at the University of
Miami no later than 5:00 p.m. Wednesday, December 17.
Please complete the form and e-mail it to ummedia@miami.edu or fax it to 305-2842035. Include a copy of your press identification with photo or a written authorization on
the letterhead of the media outlet you are representing. Credentials cannot be issued if
we do not receive all of the above requested documents.
1. Please type or write legibly the following information:
Name_______________________________________________
Name of Media Organization_____________________________
Name of Editor/News Director____________________________
Address_____________________________________________________________
City____________________ State_____ Zip _________ Country_______________
Phone Number______________________ Mobile Number ____________________
E-Mail Address___________________________ Fax Number_________________
2.
3.
4
Please check the box that best describes your outlet:
Print (newspaper)
Radio (local)
Print (magazine)
Radio (syndicated)
Print (wire/syndicated)
Photographer (newspaper) **
Television (local)
Photographer (magazine) **
Television (national)
Photographer (wire/syndicated) **
Television (international)
Internet site
Please check the box that best describes your function:
Camera / Technical Crew
Reporter (Television)
Still Photographer
Reporter (Radio)
Producer (Television)
Reporter (Internet)
Reporter (Print)
Other:_____________
How can we best contact you? Please check the appropriate box:
E-mail
Fax
Telephone
5.
The University of Miami will provide wireless access in the media filing center at no cost.
There is a nominal fee for media outlets requesting the following services, please
indicate if your coverage will require:
Ethernet connection $10
Phone line $25
Both $30
None needed for my coverage
6.
For Television: Will you be broadcasting live from the University of Miami
grounds? If yes, by what means?
Satellite
Fiber
Microwave
**NOTE: Various venues across the University of Miami Coral Gables campus will be
used for the Global Business Forum. An updated schedule will be sent to registered
media by January 9, 2009. Visit www.bus.miami.edu/gbf for more information on the
Forum.
**NOTE TO TV CREWS: Live stand-ups will NOT be permitted inside the venues during
the keynote or panel sessions. Designated on-campus areas will be provided for this.