2012Avista-NAIA World Series

NATIONAL ASSOCIATION OF INTERCOLLEGIATE ATHLETICS

2012Avista-NAIA World Series

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2012 Avista-NAIA World Series in Lewiston, Idaho, May 25 – June 1. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to Alan Grosbach () by Tuesday, May 22 at 5 p.m. CDT. All requests must be submitted via email . On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass. Details on media credential pick-up location will be communicated following the application deadline.Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a live or tape-delayed broadcast of this event unless rights for that use has been directly assigned by the NAIA. To indicate interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio Television

Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

Name: / Signature: / Date:

2012 Buffalo Funds-NAIA Division I Men’s Basketball

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2012 Buffalo Funds-NAIA Division I Men’s Basketball National Championship, March 14 – 20. All working media will be required to possess an NAIA-issued media credential to gain access to restricted areas of Municipal Auditorium.Media credentials are for working media only. Individuals under the age of 16 are not eligible for media credentials. Working media is defined as print/publication (with a circulation base), radio, or television.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to the NAIA National Office byTHURSDAY, MARCH 8 at 5 p.m. CST. Please email your credential request to or fax to 816-595-8200 attention Chad Waller.

On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass.Media credentials can be picked up at the information table located inside the main lobby at Municipal Auditorium just before you enter the arena. Photo identification/media identification is required when picking up the credential.

Type of Rights (check one): Radio Television

Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

E-mail this completed form to or fax to 816.595.8200 attention Chad Waller.

Name: / Signature: / Date:

2012 NAIA Division I Women’s Basketball

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2012 NAIA Division I Women’s Basketball National Championship in Frankfort, Ky., March 14 – 20. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to Alan Grosbach () by Friday, March 9 at 5 p.m. CST. All requests must be submitted via email . On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio Television

Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

Name: / Signature: / Date:

2012 NAIA Division II Men’s Basketball

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for 2012 NAIA Division II Men’s Basketball National Championship from March 7 – 13. All working media will be required to possess an NAIA-issued media credential to gain access to restricted areas of Keeter Gymnasium. Media credentials are for working media only. Individuals under the age of 16 are not eligible for media credentials. Working media is defined as print/publication (with a circulation base), radio, or television.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to the NAIA National Office byTHURSDAY, MARCH 1. Please email your credential request to or fax to 816-595-8200 attention Chad Waller.

On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio Television

Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

Name: / Signature: / Date:

2012 State Farm-NAIA Division II Women’s Basketball

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2012 NAIA Division II Women’s Basketball National Championship in Sioux City, Iowa, March 7 – 13. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to Jake Knabel () by Friday, March 2 at 5 p.m. CST. All requests must be submitted via email . On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo identification/media identification is required when picking up the credential.

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate interest in acquiring rights, please fill in the following:

Type of Rights (check one): Radio Television

Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

Name: / Signature: / Date:

2011 NAIA Men’s and Women’s Cross Country

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2011 NAIA Men’s and Women’s Cross Country National Championships on Nov. 19 in Vancouver, Wash. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to Alan Grosbach () by Nov. 16 at 5 p.m. CST. All requests must be submitted via email . On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass. Photo identification/media identification is required when picking up the credential.

Type of Rights (check one): Radio Television

Internet Webcast (video or audio) Web-Blogging

Broadcast rights are awarded according to guidelines set forth in the NAIA Policy Handbook

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

Name: / Signature: / Date:

2011 Russell Athletic-NAIA Football National Championship

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2011 Russell Athletic-NAIA Football National Championship on Dec. 17 from Rome, Ga. All working media will be required to possess an NAIA-issued media credential to gain access to restricted areas.Media credentials are for working media only. Individuals under the age of 16 are not eligible for media credentials. Working media is defined as print/publication (with a circulation base), radio, or television.

Please return this form to:

Matt Green () byTUESDAY, December 13 by 5 p.m. (CST).

PLEASE FILL OUT THIS FORM COMPLETELY (Type or Print)

* Required fields (State that an item is not applicable with “N/A”)

*School that outlet will cover:
*Media Outlet Name: / *Contact Person:
*Media Outlet Type:(newspaper, radio, TV, etc.)
*Address: / *City, State, Zip:
*Phone: / Cell: / *Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those that are photographers/videographers/bloggers by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Electronic media may gather appropriate images in their coverage of this event. However, those images may not be used for a live or tape-delayed broadcast of this event unless rights for that use have been directly assigned by the NAIA. To indicate interest in acquiring rights, please fill in the following:

*Type of Rights (check one):

Radio Television Internet Cybercast Web-blogging

Acceptance of a credential implies that the bearer agrees to these conditions. Click herefor Broadcast Rights Fees.

E-mail this completed form to

Name: / Date:

2012 NAIA Men’s Golf

MEDIA CREDENTIAL APPLICATION

Please use this form to request media credentials for the 2012 NAIA Men’s Golf National Championships in Salem, Ore., May 22 – 25. All working media will be required to possess an NAIA-issued media credential. Media credentials are for working media only. Working media is defined as print/publication (with a circulation base), radio or television. Individuals under the age of 16 are not eligible for media credentials.

Please note that failure to procure an NAIA-issued credential in advance of the event may result in your organization being denied credentials for the event.The NAIA reserves the right to refuse media credential requests for any reason. This form must be returned to Jake Knabel () by Friday, May 18 at 5 p.m. CDT. All requests must be submitted via email . On-site credentialing is not guaranteed.

School: / Name (if signing up as SID):
Media Outlet Name: / Media Contact Person:
Media Outlet Type:(newspaper, radio, TV, etc.)
Address: / City, State, Zip:
Cell: / Office: / Contact’s E-mail:

INDIVIDUAL NAMES FOR CREDENTIALS:

Please designate those by checking the appropriate column.

Name / Photo / Video / Radio / Writer / Blogger / SID

Credentials are issued on a conditional basis to those media who will be working at this event. The credential is non-transferable and any unauthorized use could result to revocation of the credential, ejection from the venue and prosecution for criminal trespass. Details on media credential pick-up location will be communicated following the application deadline. Photo identification/media identification is required when picking up the credential.