Get Started Please enable JavaScript in your browser to complete this form.Account CredentialsUsername *Password *Company DetailsFull Name *FirstLastTitle *Company Name *Company Phone *Company Email *Ticker Symbol (if available)IndustryWebsitePersonal EmailI further authorize the individuals listed below to request and approve content on behalf of the above public company:NamePhoneEmailNamePhoneEmailNamePhoneEmailAuthorization *I authorize MCAP MEDIA, LLC to issue a company wirepress release on our behalf and using our public ticker symbol. I have authority to legally bind the company and to provide this authorization*. This form may be digitally signed or signed by hand. Authorization form MUST be signed by a C-level of below public company and MUST include a valid company email, title and contact details from the company domain prior to MCAP MEDIA, LLC providing Wire Press Releases. NO Yahoo, Hotmail, Gmail or personal email will accepted; nor will ADMIN@ IR@, INFO@ or PR@ via company email.Upload Identification Document (Passport or Driver's License) * Click or drag files to this area to upload. You can upload up to 2 files. Signature *Clear SignatureSubmit