APPLICATION FORM

for AIPS card 2024/2025

First name: …………………………………………………………………………………………..

Family name: ………………………………………………………………………………………..
AIPS card No. In 2022/2023: ……………………………………………….
Nationality:…………………………………………………………………………………………………...

Date of birth: Day…………. Sex: Male

Month……….. Female
Year………….

Media: …………………………………………………………………………………………………………..
Function:………………………………………………………………………………………………………...
You are working as (please mark only one)
Written press
TV
Radio
Photographer

Branch/es of sports you cover

…………………………………………………………………………………………………………………

Mailing adress:
Street: ………………………………………………………………………………………………………...…

Town: ………………………………………………………. Zipcode: …………………………………….

Country: …………………………………………………….

Telephone: ………………………………………………….

Fax: …………………………………………………………

E-mail: ……………………………………………………...

………………… ……………………………………………..
Date Signature and stamp of the National
Sport Journalist Assoctation