True North Media Application
Thanks for your interest in joining us.

To apply for media accreditation to cover the conference and its speakers, please complete the application below.

**Please note freelance journalists and photographers are required to be on assignment from a media outlet.**

Contact Samantha Clark, Public Relations Manager, if you have any questions at samantha.clark@communitech.ca or 519-221-3466.

Applicant's Name *
Your answer
Primary journalist/reporter's full name *
Your answer
Job title *
Your answer
Applicant's Phone Number *
Your answer
Applicant's Email Address *
Your answer
Full mailing address *
Your answer
Affiliation/Outlet Name *
Your answer
URL *
Your answer
Official twitter handle
Your answer
Media type *
Required
Distribution *
Circulation/Viewership *
Your answer
Please explain which speakers and angle you are interested in covering *
Your answer
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