application form for accreditation to practice journalism in the

Promoting freedom, responsibility and professionalism of the media
APPLICATION FORM FOR ACCREDITATION TO PRACTICE JOURNALISM IN THE REPUBLIC OF RWANDA
FORMULAIRE DE DEMANDE D’ACCREDITATION POUR PRATIQUER LE JOURNALISME EN REPUBLIQUE DU RWANDA
1. Name /Nom……………………………………………………………………………………………………..
2. First Name/Prénom……………………………………………………………………………………………
3. Nationality/Nationalité…………………………………………………………………………………………
4. Passport number/N˚ de passeport…………………………………………………………………………...
5. Visa number/N˚ de Visa……………………………………………………………………………………….
6. N˚ of service card/N˚ de la carte de service………………………………………………………………...
7. Domain of professional specialisation/Domaine professionnel de spécialisation………………………
8. Type of Reporting/Type de Reportage
 Photo
 Film
 Radio
 Writing
 TV
9. Information on reporting activities to be conducted in Rwanda /Informations supplémentaires sur le
reportage á effectuer au Rwanda ……………………………………………………………………………………
10. Working for/Travaille pour le compte de …………………………………………………………………………….
As/comme (Job title in medium/titre dans le medium)………………………………………………………………
11. Duration of stay in Rwanda /Durée de séjour au Rwanda………………………………………………………....
12. Address while in Rwanda/Adresse au Rwanda(City, district, sector)……………………………………………..
Note
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Official letter requesting accreditation
Provide 2 passport photos/Remettre 2 photos passeport.
Provide photocopy of passport/Remettre une copy de passeport.
Provide photocopy of visa/remettre une copie de visa.
Provide photocopy of press card issued by a competent authority/Remettre une copie de la carte de presse
délivrée par l’autorité compétent.
Provide receipt of payment from RRA for non EAC members (To be determined) / Remettre un bordereau
de paiement délivrée par RRA pour les non membres du EAC (sera determiné)
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Date of application/Date de demande………………………………………………………………………………..
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Applicant’s Signature/Signature……………………………………………………………………………………………
BP. 6929 Kigali-Rwanda «» Tel: +250 252 570 333/4 «» Website: www.mhc.gov.rw «» Email: [email protected]