ESO Supernova Media Newsletter
* Required
First Name
*
Your answer
Last Name
*
Your answer
Name of Media Outlet
*
Your answer
Type of media outlet
*
tick all that apply
National newspaper
Regional newspaper
Monthly publication
Weekly publication
Scientific magazine
Picture desk
Website
TV and movie producer
TV channel
Radio station
Press Agency/Wired service
Blogger
Freelancer
Other
Required
If other, which one?
Your answer
Department
*
Your answer
Position
Your answer
Language
Choose your preferred language
Choose
English/United Kingdom
English/US
English/Ireland
Albanian
Czech
Danish
Dutch
Dutch/Belgium
Finnish
French
French/Belgium
French/Switzerland
German
German/Austria
German/Belgium
German/Switzerland
Icelandic
Italian
Italian/Switzerland
Norwegian
Polish
Portuguese/Portugal
Portuguese/Brazil
Romanian
Russian
Spanish
Spanish/Chile
Swedish
Turkish
Ukrainian
Do you write reviews?
No
Yes, for books
Yes, for apps
If other, what kind of reviews?
Your answer
Street
Your answer
City and Zip code
Your answer
State/Prov/Region
Your answer
Tax Code
(for Argentina, Brazil, Paraguay, etc.)
Your answer
Country
*
Your answer
Telephone
Eg. +49 176 000 000 00
Your answer
Email
*
Your answer
Website/personal webpage
Your answer
Social Media
Your answer
Submit
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy