Page Header

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

Brian McClendon, USA
Champion of the Earth 2013 - Entrepreneurial Vision

Technology has evolved so quickly and there's so much that can be changed by taking the power of computers and applying it to problems that have been vexing humanity forever.


In the News

Laureates