M.O.B.B. United's 2nd Annual Champions of Change Breakfast: Press Credential Request Form
All of the following information must be completed in order for your press credential request to be considered.  Any missing information will void your request.  Credentials are prioritized based on platform and reach.  Questions? Email Nikkia McClain, Tene Nicole Marketing & Public Relations (nikkia@tenenicole.com)

Sign in to Google to save your progress. Learn more
Contact Person (First & Last Name, Title) *
Media Outlet *
Email address *
Cell number *
What type of credential(s) are you requesting? (Note: One allowed per print outlet; no more than two allowed for TV/digital outlets with video cameras) *
Required
Please provide your social media handles/links for Instagram, Facebook, Twitter, etc. *
Media contact for pass (#1)  (Name as it appears on gov't ID) *
Media contact for pass (#2) (Name as it appears on gov't ID) *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Tene Nicole.

Does this form look suspicious? Report