Personal data
Surname
*
First name
*
Gender
*
--- Choose Gender ---
Man
Woman
Contact Information
Address
*
Zipcode
*
City
*
Country
*
--- Choose Country ---
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua & Barbuda
Antilles
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bohemia
Bolivia
Bosnia & Herzegovina
Botswana
Brazil
British Virgin Islands
British West Indies
Brunei Darussalam
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Ceylon
Chad
Chile
China
Chinese Taipei
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Czechoslovokia
Democratic Rep. of the Congo
Democratic Yemen
Denmark
Djibouti
Dominica
Dominican Republic
DPR Korea
Ecuador
Egypt
El Salvador
England
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
Formosa
France
FYROM
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
I. R. Iran
Iceland
India
Indonesia
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos PDR
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mauritania
Mauritius
Mexico
Micronesia
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Zealand
Nicaragua
Niger
Nigeria
Northern Ireland
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
PDR Yemen
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Republic of Moldova
Rhodesia
Romania
Russia
Rwanda
Saint Kitts & Nevis
Saint Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Scotland
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Smyrna
Solomon Islands
Somalia
South Africa
Southafrica
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tahiti
Tajikistan
Thailand
Timor-Leste
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Uganda
Ukraine
United Arab Emirates
United Arab Republic
United Kingdom
United Republic of Tanzania
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands
Wales
Yemen
Yemen Arab Republic
Zaire
Zambia
Zimbabwe
E-mail
*
E-mail
*
(C)
Mobile
*
Professional Data
Type of media
*
--- Choose Type of media ---
Newspaper
Television
Magazine
Internet
Other media
Name of the media
*
Function
*
--- Choose Function ---
Journalist
Photograher
Camera man
Technician
Press card no.
*
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