Media Form for 3rd Annual African Awards

Thank you for your interest in the 3rd Annual African Awards. We welcome all media support before, during and after the festivities. For timely consideration and follow up please submit your press credentials by filling out the form below. A request must be submitted for each individual representing your outlet. Deadline for submissions is April 10, 2016.

Full Name

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* 1. Full Name

Company

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* 2. Company

Street Address

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* 3. Street Address

State, City, Zip

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* 4. State, City, Zip

Telephone

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* 5. Telephone

Cell Phone

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* 6. Cell Phone

Email Address

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* 7. Email Address

Media Type

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* 8. Media Type

Media Coverage

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* 9. Media Coverage

Type of Media

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* 10. Type of Media

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