X Foreign Media / FOCAP Local

Name
BAUTISTA RONN JOSHUA CACAYAN
Family Name First Name Middle Name Nickname

Media Agency CHANNEL NEWSASIA

Designation/Position in agency CAMERAMAN
(indicate if freelance)

Name of Head of Office: BUENA BERNAL

Office Address: UNIT 2115, ETON TOWER, DELA ROSA STREET,
Tel. No.: (027) 505 4301
LEGAZPI VILLAGE, MAKATI CITY
Home/Hotel Address in the Philippines/Tel. no.:
189 MAGINHAWA STREET, QUEZON CITY Personal Data:
Email Address: RONNBAUTISTA@GMAIL.COM Gender: X Male Female

Mobile Phone No.: 09995302066

Birth Date: SEPT. 2, 1996 Birth Place: MANILA
Please check type of media organization you
Citizenship: FILIPINO National ID #__________
represent

Newspaper Radio

Magazine Photo Agency

News Agency Documentary

ACCREDITATION REQUIREMENTS
Others (Specify) X Television
1. Accreditation forms properly filled up.
_______________________
2. Letter of Request from respective
agencies.
3. 2pcs. 2”x2” colored pictures with white
I hereby certify all above information are true and correct
background.

___________________________________________
Signature of applicant
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Recommending Approval :_____________________ Date Received__________________

IPC HEAD
Media Media Service
Noted by :_____________________
Approved by :__________________