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Application Form

Fields marked with * are mandatory
1. Personal details
Surname*:
First name(s)*:
Gender*: Male Female
Nationality*:
Address*:
Country*:
E-mail address*:
Telephone number*
(including country code):
2. Media Organisation Details
Name of media organisation*:
Address*:
Type of medium*:

Other:
Employment status*:

Other:
Press card No*:
Name of supervisor*:
Supervisor's telephone number*:
Supervisor's email address*:
Working language(s)
of your media organisation*:
Your main topic(s)
of interest *:
3. Supporting documents
Press card*
(JPEG, PDF or TIFF Files ONLY
Max 2MB)
ID/Passport*
(JPEG, PDF or TIFF Files ONLY
Max 2MB)
4. Deadline for Application: 9 May 2011




Quotes

Janez Potocnik, Slovenia
Champion of the Earth 2013 - Policy Leadership

Unless we change the way we produce and consume we will face a crisis in our natural resources. It is crucial that we make the necessary changes now rather than when we hit environmental tipping points.


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