Broadband Traffic Management 2012 - Press Accreditation Form

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Please complete the form below. The following details will appear on your conference badge.

NB: Please also fax or email to sarah.northwood@informa.com –

Letter of assignment on official letterhead of a media organization signed by the Publisher/Assignment Editor, Editor-in-chief or Bureau Chief, specifying the name and functional title of the journalist. Unsigned letters or e-mails will not be accepted.
Photocopy of a valid press card/work pass
Photocopy of passport/national ID card

* Required Information

Personal Information

First Name *
Surname *
Publication
Job Title *
Email
Press Card Number
Contact Me	Yes
Contact My PA	Yes

Contact Details

Address Line 1 *
Address Line 2
Address Line 3
Town/City *
State/County *
Postal or Zip Code *
Country *
Tel
Mobile (PLEASE ENSURE THAT YOU PROVIDE A MOBILE NUMBER SO THAT WE CAN CONTACT YOU DURING THE EVENT)
Fax

PA Contact Details

Address Line 1 *
Address Line 2
Address Line 3
Town/City *
State/County *
Postal or Zip Code *
Country *
Tel
Mobile (PLEASE ENSURE THAT YOU PROVIDE A MOBILE NUMBER SO THAT WE CAN CONTACT YOU DURING THE EVENT)
Fax

Event

I will attend the full conference	Yes No
Day & Time Of Arrival At the Event

To update your details or to be removed from our database please contact:
The Database Manager,
Informa UK Ltd,
29 Bressenden Place,
London,
SW1E 5DR

Tel. 0207 017 4555
Fax. 0207 017 7824
Email: database@informa.com

2012 Sponsors

Gold Sponsors