NAME OF MEDIA OUTLET :

MAILING ADDRESS :

CITY / STATE:

ZIP : (Include 9 digit zip code)

PHONE NO(S) : FAX :

EMERGENCY CELL PHONE NO(S) :

E-MAIL ADDRESS :

COMPANY WEB PAGE ADDRESS :

SPORTS EDITOR/DIRECTOR :

PREP SPORTS EDITOR/DIRECTOR :

LIST EMAIL ADDRESS HERE TO BE PLACED ON PRESS EMAIL LIST :

WORKING STAFF CREDENTIAL LIST: PRESS




















WORKING STAFF CREDENTIAL LIST: PHOTO




















NO. OF SCHOOLS REGULARLY COVERD : NO. OF LEAGUES :

LIST LEAGUES REGULARLY COVERED: (List schools if less than 5 schools)

RETURN BY JULY 11, 2008 TO:
ANITA FOPMA, CIF-SS, 10932 Pine Street, Los Alamitos, CA 90720
***IMPORTANT NOTICE: MEDIA OUTLETS FAILING TO RETURN THIS FORM WILL BE REMOVED
FROM THE CIF-SS MEDIA EMAIL/MAILING LIST FOR THE 2005-2006 SCHOOL YEAR. APPLICATION
DOES NOT GUARENTEE ACCEPTANCE. A VERIFICATION CHECK WILL BE CONDUCTED ***