Media Application

Contact Details

Media Project Name *

First Name *

Last Name *

Email *

Phone *

Address *

Suburb / City *

Postcode *

State

Country *

Project Details

Media Type

Select which category best describes your project.

Organisation

If you work for a media organisation, please enter the name of the organisation here.

File Upload

Maximum file size: 104.86MB

Website

Please enter your Website URL - it should be in the format http://www.yourwebsite.com

Facebook Link

Please enter your Facebook Page URL

Instagram Link

Please enter your Instagram Page URL

Youtube Link

Please enter a Youtube link which gives an idea of your proposed project.

Vimeo Link

Please enter a Vimeo link which gives an idea of your proposed project.

Number of viewers/circulation

If you work for a digital or physical publication, enter the number of viewers/circulation here.

Description of intended media activity *

Names of people in your crew and their roles *

Please provide a list of all people involved in your project and their role.

Any comments / questions / suggestions ? *

Please provide a list of all people involved in your project and their role.

Financial & Insurance Details

Fee Request *

What are you looking for in return?

Travel Arrangements & Costs

ABN *

If you have an ABN, please enter it here.

GST

Do you have Public Liability Insurance

Emergency Contact Details

Emergency Contact Full Name *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Medical Conditions

Please list any medical conditions you have that should be known by the event organisers.

Captcha

If you are human, leave this field blank.