Bupa Great South Run

23rd/24th October 2010, Southsea, Portsmouth Media Accreditation Form (Please complete and return before Monday 18th October 2010). Email: nicola.hedley@nova-international.com or Fax: 0191 272 7036

NAME OF PERSON TO BE ACCREDITED: ORGANISATION: ADDRESS OF ORGANISATION: CITY/TOWN: POST CODE: COUNTRY: TELEPHONE NUMBER: EMAIL ADDRESS: EVENT: Bupa Junior & Mini Great South Run ( ) Bupa Great South Run ( ) AREA: Please stipulate: * Start/Finish ( ) * On Course ( ) FUNCTION: *Tick appropriate box *Written Press( ) *Photographer( ) *Television ( ) *Radio ( ) *Other ( ) Please stipulate: THIS FORM MUST BE RETURNED BY MONDAY 18TH OCTOBER 2010: nicola.hedley@nova-international.com Fax: 0191 2727036 A detailed event timetable will be sent upon accreditation

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