Press Registration Survey

Rural Health Transformation Fund Convening

Thank you for your interest in attending the Rural Health Transformation Fund Convening as a member of the press.

Due to capacity limits, in-person general admission is full. A limited number of spaces are available for credentialed media only. Please complete this form to request access to in-person media coverage on Thursday and Friday. An online attendance option is available on Wednesday, January 14. If you are unable to attend in person on Thursday or Friday, daily recaps will be available on the DOH website.

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* 1. Full Name

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* 2. Email

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* 3. Phone

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* 4. Media Outlet / Organization

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* 5. Job Title / Role

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* 6. Will you be attending as a credentialed member of the press?

Yes

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* 7. Type of Media

Television

Radio

Online / Digital

Other (please specify)

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* 8. Attendance Acknowledgements (select all, this is subject to change)

I understand I will be standing in a designated press observation area.

I understand I may listen to plenary sessions and breakout sessions.

I understand I will not be permitted to ask questions during sessions or breakout discussions.

I understand I must bring valid press credentials or media identification for entry.

I agree to be respectful of the convening format and participants.

I understand space is limited and submitting this form does not guarantee approval.

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* 9. If you anticipate having questions related to the convening, please note them here.

*Submit media questions to Shirley at shirley.sakaye@alaska.gov on the Alaska Department of Health Communications team. Responses will be provided as availability allows.

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* 10. Acknowledgement and Submission

I confirm that the information provided is accurate and that I agree to all press attendance guidelines outlined above.

Press Registration Survey

Rural Health Transformation Fund Convening

Question Title

* 1. Full Name

Question Title

* 2. Email

Question Title

* 3. Phone

Question Title

* 4. Media Outlet / Organization

Question Title

* 5. Job Title / Role

Question Title

* 6. Will you be attending as a credentialed member of the press?

Question Title

* 7. Type of Media

Question Title

* 8. Attendance Acknowledgements (select all, this is subject to change)

Question Title

* 9. If you anticipate having questions related to the convening, please note them here.*Submit media questions to Shirley at shirley.sakaye@alaska.gov on the Alaska Department of Health Communications team. Responses will be provided as availability allows.

Question Title

* 10. Acknowledgement and Submission

* 9. If you anticipate having questions related to the convening, please note them here.

*Submit media questions to Shirley at shirley.sakaye@alaska.gov on the Alaska Department of Health Communications team. Responses will be provided as availability allows.