MEDIA OFFICER: Jan Mansfield

` T: 604.657.3828; F. 604.926.4333

E: januscom@shaw.ca

MEDIA ACCREDITATION APPLICATION FORM

Individual Requesting Accreditation: ______________________________________

Address: _______________________________________________________________

City:_____________________________ State:_____________ Zip Code:___________

Telephone: __________________________Fax: _______________________________

Email: _______________________

Company/Affiliation: ___________________________________________________

Name of Director/Editor: ________________________________________________

Telephone: __________________________Fax: _______________________________

Email: _______________________

· Capacity in which you will be covering PAC 2003:

_ Equestrian Writer/Reporter

_ Newspaper Reporter

_ Television Reporter

_ Radio Reporter

_ Still Photographer

_ Camera person

_ Other (Specify)

· Escorted tour of trail requested? (photographers given preference) _____

· Thursday Banquet: No. of tickets ______ @$25 (payable on pick up at camp)

· Sunday Barbecue: No. of tickets _______@$20 (payable on pick up at camp)

Signature of Applicant ________________________________Date_______________

Fax completed form to Janus Communications Inc. - (604) 926-4333

or e-mail information to januscom@shaw.ca

Deadline: August 31, 2003