Name of National Federation

Person Responsible for Contact Press Office –

Title:

Address Correspondence to this person

Yes /No  

Telephone Contact # :

[    ]

Fax:

[     ]

Mobile Phone / Cell

+

Federation Address

City, State, Zip Postcode

Mailing Address:

City, State, Zip:

E-mail   (to be used for contact)

Email Private:

Courier address (for deliveries)

City, State, Zip:

*** In the situation where items need to be delivered by Courier an address is required if different to the Federation address.

Website:

Name:

Photos if available for inclusion on the BCO AND IBAF websites

Title:

Daytime Phone:

[   ]

Fax:

[     ]

Home or Work

[ - - - ]

Mobile / Cell

Mailing Address:

City, State, Zip:

E-mail:

Email 2 (if applicable)