2017 US Youth Soccer Region II (Midwest) Championships Yankton Trail Park | Sioux Falls, S.D. June 23–28, 2017
APPLICATION FOR MEDIA CREDENTIALS
NAME: _________________________________________________ POSITION: _________________________________
AFFILIATION: ____________________________________________PHONE: ___________________________________
EMAIL: _________________________________________________ TWITTER: @________________________________
ADDRESS: _________________________________________________________________________________________
AUTHORIZED SIGNATURE (EDITOR, NEWS DIRECTOR OR OTHER SUPERVISOR): ____________________________
NUMBER OF SPACES (SEATS) REQUESTED IN WORKING PRESS AREA: ____________________________________
EQUIPMENT NEEDS: If you plan to work from the Media Center, please complete the portion of the form within the box below. Please check appropriate categories:
Please check type of outlet: ÿ Print Media ÿ Photographer ÿ Radio/TV ÿ Internet
How often is your publication printed/show aired? ________________
Will you be filing daily? __________
Please note any special requests you may have: ____________________________________________________________
___________________________________________________________________________________________________
OTHER STAFF (writers, photo assistants, etc.) LIST NAME AND ASSIGNMENT:
_____________________________________________ _____________________________________________
_____________________________________________ _____________________________________________
q No. Requested q No. Approved q Notified q Mailed q Added to media list
NOTES
Media
Media credentials must be visible at all times.
Freelance
Photographers and writers must include proof of assignment on letterhead with application.
Social Media
Please use #ROADtoTX if posting content to Twitter, Facebook or Instagram.
Twitter: @USYSNCS ; Instagram: @USYouthSoccer
We must receive completed application forms no later than Friday, June 16, 2017.
Credentials can be picked up at site. No credentials will be mailed in advance. If other staff requires credentials, please copy this form, fill it out, and return it.
Credentials are NON-TRANSFERABLE. This policy is strictly enforced.
q No. Requested q No. Approved q Notified q Mailed q Added to media list
Please return no later than Friday, June 16 to:
JoEllen DeLeon, Communications Coordinator
US Youth Soccer, 9220 World Cup Way, Frisco, Texas 75033
Tel: (800) 4SOCCER Fax: (972) 334-9960 Email:
For internal use only: