Media Registration Form -
Start
10/Mar/2024 16:00
End
7/Aug/2024 16:00



Global Black Pride Media Registration


 

First Name *
Last Name *
Email *
Phone *
Provide your current living address *
Mobile
Media Category (Please select one) *

Category 1: Journalists, Photographers, and Videographers - Employees or those on assignment for recognized media outlets or LGBTQI media

Category 2: Communications Professionals - Attached to recognized non-profit advocacy, or policy organizations

Category 3: Social Media Influencers - Significant contributors to Black LGBTQI community or those with strong connections and a following of over 50,000 on social platforms.

Organization/Employer Name:
Provide the name of the media outlet or organization you are affiliated with *
Describe your role within the organization *
Media Outlet or Organization Website: [Provide the URL, if applicable]
Assignment Letter or Proof of Employment: [Attach a letter from your editor or media outlet confirming your assignment to cover Global Black Pride 2024, or proof of employment if applicable] *
(MAX SIZE 5MB)
Application Details:

● Describe your interest in covering Global Black Pride 2024.

● Explain how your coverage will contribute to the visibility and understanding of Black LGBTQI community

Justification for Application: *
Portfolio or Previous Work: [Provide links or attach documents showcasing your previous work related to HIV, public health, or similar fields, if applicable] *
Social Media Handles:
[List your social media profiles if applying as a Category 3 influencer] *
Additional Information. Special Requests or Accessibility Needs: *

Declaration:

By submitting this application, I hereby certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that media registration is complimentary, but all other expenses including travel and accommodation are my responsibility.

Date: *
Signature: *

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