Zoho Creator-

The UpTake New Media Space Credentials Application

The New Media Space is just 300 yards away from the Xcel Center, the site of the RNC. Space is available on a first come, first served basis. We will send you an email confirming your application. If we approve your application we will request a $50 donation. We will need a picture of you to put on the New Media Space credential. You can attach it to this application now, or you can send it to us with your payment after you are approved.

First Name *

Last Name *

Your Picture

email *

Phone *

Address *

Address 2

City *

State *

Zip *

Organization *

Website

Type of media *

Blog
Video/TV
Audio/Radio
Newspaper
Other

Tell us briefly about your coverage plans.

: *

Tell us how many power outlets you will need. If you need more than 3 outlets, please email noah.kunin@theuptake.org directly to discuss.

Power Outlets

0
1
2
3

Status

Report Abuse

Error

Invalid entries found. Please correct and submit again.