MEDIA ACCREDITATION APPLICATION FORM

Last Date of form Submission: 21st August 2011

First Name: VIREN Last Name: FERRAO Official Address: TIMES NOW Trade House, 1ST Floor, Kamala Mills Compound, Senapati Bapat Road, Lower Parel. Mumbai 400013 Residential Address: 201, Gurusadan D Wing, First Cross Lane, OFF N M Joshi Road, Byculla West, Mumbai 400011 Email: virenferrao@gmail Mobile: 9769135324 Telephone Nos. : (O) 02224990556 (R)......... (Fax) 02224990569 Nationality: INDIAN Country from which you belong: INDIA Type of News Organization (Tick) Print Media Electronic Media News Agency Web-Portal

Please Specify Organization: TIMES NOW Designation: (Please Specify): Correspondent

(Only for International Media)

Passport Number: . Visa Details: No. : ..

Valid from ..................................................up to Date: Date: Please attach the following documents: 1. Recent passport size photo. (Maximum 500 Kb) 2. Recommendation letter from Editor / Sports editor of the Organization. (Maximum 500 Kb) 3. ID Proof : Govt. Press Card / Voter ID Card / PAN Card / Driving License / Passport (Maximum 500 Kb)

Media Advisory:
1. Media Accreditation process is solely at the discretion of the organizers. 2. Incomplete Application forms will not be considered for Media Accreditation. 3. Accreditation requests will not be accepted after 17th of August 2011 4. For International friendly match at Yuba Bharati Krirangan on 2nd
September 2011: A. PRINT MEDIA (A.1) Maximum two reporters and two photographers from each Newspaper having ABC Circulation above 1 lakh, will be given media accreditation, subject to the capacity of the venue. (A.2) Maximum one reporter and one photographer from each Newspaper having ABC Circulation less than 1 lakh, will be given media accreditation, subject to the capacity of the venue. (A.3)In case of Magazine maximum one reporter and one photographer will be given accreditation, subject to the capacity of the venue.

B. ELECTRONIC MEDIA (B.1) Maximum one reporter and one TV Cameraman from each Satellite Channel, TV News Agency, will be given media accreditation. Radio News Broadcasters will be given accreditation for one reporter.

(B.2) Please note that, TV Cameramen from non-Broadcasting Right holder Channels are only allowed inside the premises of the Yuva Bharati Krirangan during the Post-Match Press Conference on 2nd September 2011.

C. Maximum one reporter and one photographer from each News Agency will be
given accreditation. D. Maximum one reporter from each News-Web portals will be given accreditation.

Please send the Media Accreditation form & other attachments at: footballfest2011@candidcommunication.net
For further information please contact: Candid Communication Bikram Sarkar - +91 9836195426 Dipam Saikia - +91 9883926535 Email: info@candidcommunication.net