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QCA Media Palooza Registration Form
Date:
Saturday November 23
Red Carpet: 6-7pm
Show: 7:15-10:15pm
Media Palooza: 10:30-Midnight
Address:
Oasis Shriners
604 Doug Mayes Pl
Charlotte, NC 28262
**Only Two Passes Per Company**
**Your Company Must Promote The Show If Approved**
Name
*
First
Last
Company Name
*
Email
*
What Type Of Media Are You?
*
Blogger
Radio/Podcast
Magazine
News
Website
*
Instagram
*
Upload logo
*