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Attach two colored 2x2 ID photo w/ white background

Attach two colored 2x2 ID photo w/ white background. Presidential Communications Operations Office. International Press Center. 2012 Press Accreditation Form. FOREIGN MEDIA. VISITING JOURNALIST. Date of application_______________. Name. Family Name. First Name. Middle Name. Nickname.

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Attach two colored 2x2 ID photo w/ white background

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  1. Attach two colored 2x2 ID photo w/ white background Presidential Communications Operations Office International Press Center 2012 Press Accreditation Form FOREIGN MEDIA VISITING JOURNALIST Date of application_______________ Name Family Name First Name Middle Name Nickname Media Agency Designation/Position in agency (indicate if freelance) NAME OF HEAD OF OFFICE: PERSONAL DATA: OFFICE ADDRESS: Citizenship: Tel. No.: Fax No.: Birth Date: Home/Hotel Address in the Philippines/Tel. No.: Birth Place: E-mail Address: Mobile Phone No. Gender: Male Female Status: Please check type of media organization you represent Passport No. Married, spouse name Single Issued at Newspaper Separated/Divorced Magazine Issued on News Agency Television Expiry date Height (ft/m)___________ Weight (lb/k)___________ Radio Photo Agency ACCREDITATION REQUIREMENTS Visa No./Status Documentary Others (Specify) 1. Accreditation forms properly filled up. Length of stay 2. Letter of request from respective agencies 3. 2 pcs. 2’x2” colored pictures with white background Expected places to visit in the Philippines 4. Copy of contract of employment (for local hire) 5. Photo copy of passport (pages 1& 2) 6. Letter / Endorsement from the embassy Contact person in case you are out of town Tel. No. ADDITIONAL REQUIREMENTS FOR NEW APPLICANT AND FREELANCER In case of freelance journalist and correspondent who submit stories or photographs to more than one publication, please list Media entities you are a frequent contributor. 1. 5 bylined photos (published not later than 3 mos.) 2. Five (5) consecutive issues of newspaper or magazine (for news publications not later than 3 mos.) I hereby certify all above information are true and correct Note: ID’s not claimed within two months after approval will no longer be released. Signature of applicant ------------------------------------------------------------------------- Media Media Services This part to be accomplished by accreditation officer Date received_______________________ 2012 C.N._______________________________ Date Issued______________________________ Expiry date_______________________________

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