Media credentials will allow the bearer to have access to all plenary session presentations and to schedule interviews with the Faculty. Media fee enables bearer to enjoy the catered breaks and all conference materials. Journalists requesting short stays for specific filming (such as local TV news) or less than three personal interviews may waive fees. All requests by representatives of the press - print, radio and video - to attend the conference and/or to interview the Faculty on site are required to provide the following written documentation:

* A copy of the individual(s) personal press credentials including contact information and the identity of the news organization represented.

* The theme of the report/story; the format (i.e. Periodical/ video/ manuscript); and the intended source of publication. Requests that indicate conference content will be used in some manner for profit must enter a contractual agreement with Patients Out of Time.

Name and contact information of responsible editor:

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Number/names of interviews anticipated if any:

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Names of conference attendees: Each @ $125

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Make checks payable to: Patients Out of Time - Total -    ________________

Please Print out this form and mail to: Patients Out of Time

1472 Fish Pond Rd. / Howardsville, VA, USA 24562

(434) 263-4484 * (434) 263-6753 fax - Media Contact: Al Byrne - This e-mail address is being protected from spambots. You need JavaScript enabled to view it