MODA - Media Form

Media Registration Application

Please complete the entire form below. For media outlets, kindly include a link to your website, and for content creators, please provide a link to your channel. Please note that submitting only a username will result in your application being denied.
First Name*
Last Name*
Mobile Phone*
Email*
Website / Outlet*
Title
Social Media Account

InstagramTikTokYouTube
Instagram Link*
TikTok Link*
YouTube Link*
Categories*

NewspaperTelevision ProducerMagazineRadio ReporterOnlineRadio ProducerPhotographerSocial MediaTelevision ReporterPodcastBlog
Total Audience Size

0-10k10-50k50-250k250k-1M1M+
Days Attending

FridaySaturdaySunday
Audience

CarsEntertainment/CelebrityTravelMotorcyclesLuxury/LifestyleGeneralCulinary/Food
Should be Empty:

Media Registration Application