INSCRIPTION FORM

Note: The only obligatory information are Name and Surname, current professional functions, and email

I would like to get involved in the Alternative Media Global Project. I understand that this project needs me to give contributions on a regular basis!
======Name SURNAME======
{{picture}}
=====Area(s) of expertise for the AMGP=====
* [specific geographic zone : country, continent, etc.]
* [specific type of media : radio, press, television, Internet, etc.]
* [specific issue : social movement media, community media, etc.]
===== Current professional functions* =====
*
*
*
===== Previous functions =====
*
*
=====Studies/Diploma=====
*
*
*
===== Publications =====
*
*
*
===== Contact =====
* **Phone:**
* **Mob.:**  
* **Email:**
* **Address :**
* **Fax :**
=====Other information=====
* **Date of birth :**
* **Place of birth:**
* **Male/Female:**
* **Nationality(ies):**
* **Language(s):**
How did you discover the Alternative Media Global Project ?
Would you give to the AMGP's administrators the right to publish these information on the wiki ?  
Other informations/Comments/Questions: 
appendices/administration/inscription_form.txt · Last modified: 2011/07/09 20:09 (external edit)