Media Accreditation Form

The Naval Base Coronado Public Affairs Office is accepting media reservations to attend the 2011 Naval Air Station North Island (NASNI), Naval Aviation Centennial Kick-off Air Show and Open House, February 12, 2011 and Media Day Friday, February 11, 2011.

Media representatives desiring to attend the Open House should complete the form below and fax valid state accreditation to the Naval Base Coronado Public Affairs Office at (619) 545-0182. Once the application is received, a confirmation e-mail will be sent within a few business days and does not constitute approval. If you do not receive this confirmation e-mail, please re-submit the application until confirmation is received. All request approvals will be sent out at a later date. The following information is required for NASNI Open House accreditation:

1) A separate form must be filled out for every media representative requesting accreditation.
2) Full name, job title for each representative attending, media organization the individual is representing are required. Official state or federal photo identification as well as media credentials must be faxed to 619-545-0182. Be prepared to provide either your drivers license, Social Security, Visa number, or Passport number to the Naval Base Coronado Public Affairs representative when they call to confirm receipt of accreditation forms. (All safety precautions are taken with protecting your identity.)
3) Submit a letter from your editor verifying your assignment to cover the open house; if an editor is not available, submit a letter of intention explaining your purpose for attending the open house.
4) Official state or federal photo identification as well as media credentials are required when checking in with a public affairs representative at the gate. They must match the credentials that were used when submitting this form.
5) Are you a U.S. citizen? Yes No Please fax federally endorsed, photo identification with cover sheet addressed to the Public Affairs Office: 619-545-0182.

After completing this online form, your information will be submitted to the Naval Base Coronado Public Affairs Office. If you have any questions please call the Public Affairs Office at 619-545-8167 or 619-545-8136. Deadline to register for press credentials is February 4, 2011.

Last Name*:

First Name*:

MI:

Job title*:

Name of Organization:

Type of Organization:

Area of Coverage:

Day Phone*:
Ext:
Evening Phone:
Ext:

Your Email Address*:

Fax:

Dates Attending*:
Media Day, Feb. 11 Open House, Feb. 12
Total Number of Personnel Attending*:

Mailing Address:

Address*:

City*:

State*:

Zip*:

Employment Status*:

All Freelance Media:

Name and model of equipment being used:

Link published work below. If links not available, photocopy and fax a copy to our media relations department at (619) 545-0182 or you may scan and email a pdf to our public affairs box: mailto:nbc_comrel.fct@navy.mil.