MEDIA CREDENTIAL REQUEST FORM

PLEASE NOTE: THIS FORM MUST BE RETURNED BY OCTOBER 15 TO RECEIVE CREDENTIALS BY MAIL.

1. Name:
2. Name of Organization:
3. Mailing Address:
4. Email Address:
5. I provided pre-event publicity and would like  (maximum of four) complimentary Infield tickets. One parking pass will be permitted per media organization. I would like  (maximum of four) working media credentials. One parking pass will be permitted per media organization.
6. I will provide race day coverage:	YesNo
7. Electronic media please indicate special needs (NOTE: electronic media allowed for news coverage only):

If you prefer to pick up at the Steeplechase Office in Columbus, please call 706-324-6252 to set an appt (before 5pm, Wednesday, October 31^st) Office number is: 706.324.6252

If you prefer to pick up at Will Call, Will Call opens at 10am on Race Day.