Media Accreditation and Liaison Unit

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ACCREDITATION APPLICATION FORM

Personal information

	Salutation* Mr. Ms. Mrs. Miss
	First name* MI Last name*		Phone* (country · area · number) Fax (country · area · number) Mobile/Cell (country · area · number)		Citizenship* Date of birth* Place and country of birth*

Permanent address
Street*	City* Postal/Zip code	Country*
For the purpose of creating your personal Accreditation Account, please choose a password between 6 and 8 characters long. The characters can be letters and/or numbers with no spaces between them.
Choose Password:*	Confirm Password:*	E-mail*

Media organization

	Name of organization*		Web address
	Supervisor name* Supervisor phone* (country · area · number)		Headquarters street address* Headquarters city* Headquarters Postal/Zip code Headquarters country*		Local address (if applicable) Local street address Local city Local Postal/Zip code

INFORMATION REQUIRED BY UN SECURITY FOR ISSUANCE OF A GROUNDS PASS *

Home address while working at UN Headquarters. same as Permanent address
	Street*		Postal/Zip code City*

	Emergency contact
	First Name	Last Name
	Phone* (country · area · number)	Mobile/Cell (country · area · number)

Additional Personal information*

Hair colour

Eye colour

Height [cm]

Weight [kg]

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Weight/Height

Note(maximum message length of 1,000 characters)

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IMPORTANT NOTICE & NOTE ON BONA FIDE MEDIA ORGANIZATIONS read

I have read and agreed to the above notice and rules governing media access, press conferences and briefings and will forward the letter of assignment by fax to 1-212-963-4642 or as scanned document in .jpeg or .pdf format to malu@un.org. Without a duly signed letter of assignment no application for accreditation or renewal of accreditation will be considered.