MITE

Hosted Media Registration

Fields marked with * are required

Name *

Company Name *

Position / Title *

Contact Address

Phone (Work)

Phone (Home)

Email *

Mobile *

Have you been to Malawi before?

If so, when and where?

Do you smoke?

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Other Details

Next of Kin

Next of Kin Contact Address

Next of Kin Mobile

Next of Kin Email

Upload a copy of your passport .

1. Provide a short company profile including type of clientele, age spend per person.

2. Provide proof of editor’s concession that articles will be published in respective media. *

3. Circulation numbers for respective media (online & offline).

4. Target readership (budget, middle or upmarket).

5. Any other pertinent information.

I agree to the terms and conditions found here