MEDIA REPRESENTATIVE FORM

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I would like to attend, or interview one of the keynote speakers at, the upcoming Tapping The Source - Mental Health Summit, Creating Inner Peace and Resiliency In Challenging Times. Which includes international leaders, scientific experts and spiritual teachers - Dr Demartini, Queen Diambi, Dr. & Master Zhi Gang Sha and Dr. Rulin Xiu.

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MEDIA NOTE: The FIRST 50 MEDIA REQUESTS for interviews, will receive a complimentary ticket to the Tapping The Source - Mental Health Summit.

Full Name *

Media Outlet *

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Interview Intentions - How would you best like to cover this event?
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Are you interested in an online Media Scrum following this event for interview purposes?
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If you are one of the media representatives to request an interview, will you require a complimentary pass to the event, to cover the story?
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Yes

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