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Media Registration

FAX OR EMAIL the completed form (together with media accreditation documents) to the ECCO Communication Department: Fax: +32 (0)2 775 02 00, email: riitta.kettunen@ecco-org.eu

Media Free Registration Application for the 26th EORTC-NCI-AACR Symposium on “Molecular targets and cancer therapeutics” in

Barcelona, Spain, 18-21 November, 2014

Free registration is available for bona fide media representatives. ALL media are required to enclose a copy of a recognised press card or a commissioning letter from the editor of a recognised publication when returning this form AND to present them at the conference together with valid passport or ID-card.

I will attend the EORTC-NCI-AACR Symposium in Barcelona, Spain, 18-21 November 2014. I am unable to attend the EORTC-NCI-AACR Symposium but would like to receive daily news by e-mail. I agree to abide by all the EORTC-NCI-AACR media embargoes.NB: you must agree to abide by the media embargoes otherwise your registration will be refused.

First name: .......................................................................................................................................................

Family name: ...................................................................................................................................................

Representing: ..................................................................................................................................................

Job Title: .........................................................................................................................................................

Address: ..........................................................................................................................................................

Postal code: .....................................................................................................................................................

Country: ..........................................................................................................................................................

Telephone Intl.: ...............................................................................................................................................

Fax: .................................................................................................................................................................

E-mail: ................................................................................………………………………………….………

URL/Internet address: ………………….........................................................................................................

I enclose a copy of my Press card I enclose a copy of a commissioning letter from the editor of a recognised publication

Type of publication:

Newspaper (National/Regional)* Magazine (N/R)* News Agency (N/R)* Scientific Journal (N/R)* Radio (N/R)* TV (N/R)* Website Other (please specify)………….…………………..

*Please indicate whether you are National (N) or Regional (R) media in your own countryArea: News/ Science/ Research & Development/ Health/ Other (please specify)…………….…............

Please note: Advertising, marketing and public relations staff of journals or companies are NOT eligible for free media registration. Please consult the media policy for the EORTC-NCI-AACR Symposium at www.ECCO-org.eu