First Name:

Last Name:

Title:

Company:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

E-Mail:

You will receive a confirmation email at this address

B. What You Need

I am interested in (check all that apply):

press pass
photo pass
I'd like to conduct a pre-interview with a panelist or FMC representative
I am part of a TV/video crew that needs audio feeds or mult box hookups

C. Some Info About You

Best description of your current participation in the music industry (check one only):

I have attended other FMC events, like the Policy Summit
I have attended other ACS or Center for American Progress events

D. Important Issues

What issues are most interested in covering at this event?

E. Accessibility

Please let us know you need accommodations for any of the following:

F. Comments? Special instructions?