Apply for Broadcast Media Credentials

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Broadcast media journalists can apply for credentials using the form below.

PLEASE NOTE: Any guests appearing on your broadcast during the time of the Conference will be required to register at the full attendee rate. No exceptions will be given.

Print media: apply for credentials using the print media credential form.

Primary Contact Information

Name

Title

Company

Phone

Email

Fax

Company Address

Street Address

City

State

Zip Code

Engineer Contact Information

Name

Title

Company

Phone

Email

Additional Media Crew

Name

Title

Company

Email

Name

Title

Company

Email

Name

Title

Company

Email

Name

Title

Company

Email

Name

Title

Company

Email

Media Information

Type of Media
 Television Radio Online Other
If other, please specify:

What will you be covering?

Broadcasting

Due to contracts with Conference speakers, video and audio recordings of some speakers at the Detroit Policy Conference may be restricted or may not be allowed.

What is your estimated arrival time?

What is your estimated tear-down time?

Please specify broadcast times
Start Time: End Time:

Technical and Setup Needs (check all that apply)

6'Table with cloth
 Yes No

Chairs (two chairs)
 Yes No

Electrical power (one 15 amp power source)
 Yes No

Power strip (one 5-outlet power strip)
 Yes No

Need anything else? Tell us here if you have any special requests:

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How Can We Help?
Your Name (required)

Your Email (required)

Subject

Your Message

Input the Letters
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How Can We Help?
Your Name (required)

Your Email (required)

Subject

Your Message

Input the Letters
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