ACCREDITATION FORM

This service is reserved to media people.

press service
Uni-d-fox- Karine Devilder
13, Bayens 33570 Puisseguin- France
tel:+33 (0)5 57 74 50 81- fax: + 33 (0)5 57 74 50 82
e-mail:contact@unidfox.com

INFORMATIONS FORM

Company *:
Name *:
First Name* :
Function* :
Adress* :
Postal Code *:
City* :
Country* :
Phone* :
Fax* :
Mobile :
E.mail* :

Press card number: *:

Media's Type * :

	Press agency
	Daily newspaper
	Weekly newspaper
	Monthly
	Photo agency
	Web Site
	Radio
	TV
	Free lance
	Others

TO GET ACCREDITED

To fill if you intend to come to La Baule CSIO:

arrival's date:	MAI 2004
departure's date :	MAI 2004

*technical facilities requested:**
	Desk in the press center
	with electrics plugs
	Seat in press stand
	with electrics plugs
	Locker
	Photo armband
	Internet connection ADSL

other request :

Informations given by you are transmitted to the website labaule-cheval.com. You can have a right of access to those informations, change them or modify some of the data (art.34. of the law "informatiques et libertés"). To exercise your right, get in contact with Unidfox, 13 Bayens - 33570 Puisseguin ou contact@unidfox.com

* Requested