Media Registration

*Media Function - Select Function -  Print Journalist  TV Journalist  Radio Journalist  Web/Wire Journalist  Technician (TV/Radio)  Photo Journalist (Still Photography)  TV Cameraman

*Title - Select Title -  Mr.  Mrs.  Ms.  Dr.  Engg.  Prof.

*First Name

*Last Name

*Designation

*Company/Organisation Name

*Address Line 1

Address Line 2

*City

*Pin/Zip Code

*State

*Country Select Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Argentina Armenia Australia Austria Azerbaijan Bahrain Bangladesh Belarus Belgium Benin Bhutan Bolivia Bosnia And Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Costa Rica Croatia Cuba Cyprus Czech Republic Democratic Republic of Congo Denmark Djibouti Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Guatemala Guinea Guyana Haiti Herzegovina Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyz Republic Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Mauritius Mexico Moldova Monaco Mongolia Morocco Mozambique Myanmar Namibia Nepal Netherlands New Caledonia New Zealand Niger Nigeria North Korea Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Congo Romania Russia Rwanda Saudi Arabia Senegal Serbia And Montenegro Seychelles Sierra Leone Singapore Slovakia Somalia South Africa South Sudan Spain Sri Lanka Sudan Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vatican City St. Venezuela Vietnam Yemen Zambia Zimbabwe

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Whether PIB or State Accredited Journalist? Select Option Yes No

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