Fifth International World Wide Web Conference

May 6-10, 1996, Paris, France

Media Accreditation Form

Please, print and complete this form after having read carefully the instructions and procedure and return to:

Fifth International World Wide Web Conference - PRESS OFFICE
Ms Jackie Phillips
Andrew Lloyd & Associates, Ltd.
Brighton Business Center
95 Ditchling Road
Brighton BN1 4ST
United Kingdom

Tel: +44 1273 675 100
Fax: +44 1273 675 400

E-mail: allo@ala.com

When using electronic mail, please, copy this text only version of the accreditation form.

Mrs |_|   Ms |_|   Mr |_|

NAME:       |_____________________________________

FIRST NAME: |_____________________________________

TITLE:      |_____________________________________

CATEGORY (please check):

Trade Press             |_|  Daily Press              |_|  TV Station     |_|
Economic/business Press |_|  Technology Correspondent |_|  Radio station  |_|
                        |_|  Business Correspondent   |_|  Press agency   |_|
                                                           Photographer   |_|

NAME OF PUBLICATION/PRESS AGENCY/RADIO STATION:

            |_____________________________________

NAME OF TV STATION:

            |_____________________________________

ADDRESS OF PUBLICATION/RADIO OR TV STATION/PRESS AGENCY:

            |_____________________________________
            |_____________________________________

COUNTRY:    |_____________________________________

ADDRESS WHERE DOCUMENTATION SHOULD BE SENT IF DIFFERENT FROM ABOVE:

            |_____________________________________
            |_____________________________________

COUNTRY:    |_____________________________________

TELEPHONE:  |_____________________________________
            (country code, area code, telephone number)

FAX:        |_____________________________________
            (country code, area code, fax number)

E-MAIL:     |______________________________________
            (Internet format)


For TV journalists, please indicate the name and title of accompanying
staff (director, cameraman, technician, etc.), if any. Use additional
sheets if required:

NAME:       |_____________________________________

FIRST NAME: |_____________________________________

TITLE:      |_____________________________________


I would like documentation in English/French    E |_|   F |_|

I intend to cover (please check):  
	the Tutorials  |_|  the Technical Program |_|
	the SMEs Forum |_|  the Developer's Day   |_| the Exhibition |_|

I intend to be at the Fifth International World Wide Web Conference 
on the following day(s):
	May 6 |_|   May 7 |_|   May 8 |_|   May 9 |_|   May 10 |_|

I would like to have vegetarian meals: YES |_|   NO |_|

I do not want my personal information to be included in the public 
attendees list: YES |_|   NO |_|


DATE:               SIGNATURE: