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* 1. Journalist First Name & Surname

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* 2. Organisation/Publication

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* 3. URL of publication

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* 4. Email address

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* 5. Mobile

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* 6. What is the size of your audience?

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* 7. What are you seeking to gain/publish from attending the conference??

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* 8. Will we be able to review the content before it is published?

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* 9. Would you be willing to promote the conference ahead of time to help attract attendees if you were provided with a media pass? - if so how much marketing would you provide?

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* 10. Any other comments

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