600-00052 One Time Registration
STATE OF VERMONT
One-Time Registration for Media Individuals
Submit this application to court staff for consideration by the Presiding Judge of the unit, if the proceeding is in the
superior court, or the Chief Justice, if the proceeding is in the Supreme Court.
Name of Organization (if any): ____________________________________________________
Name of Person Requesting Authorization: ___________________________________________
I am requesting authorization for this date: _____________________________________________; or
for this proceeding (case name and hearing type): ___________________________________________
in (Unit/Division or Supreme Court): ______________________________________________________
I certify that:
1. I have read and understand the terms of Vermont Rule of Civil Procedure 79.2, Vermont Rule of
Appellate Procedure 35 and Vermont Supreme Court A.O. 46 and will comply with the provisions of
those rules.
2. I am a member of the Media, as defined in V.R.C.P. 79.2(b)(6), because I regularly gather, prepare,
photograph, record, write, edit, report, or publish news or information about matters of public
interest for dissemination to the public in the following publication(s) or broadcast news outlet(s).
(Describe your work):
____________________________________________________________________
____________________________________________________________________
Signature: _________________________________________
Printed Name: ______________________________________ Date:
DECISION
(This section to be completed by the Presiding Judge of the unit, if the proceeding is in the superior court, and
by the Chief Justice, if the proceeding is in the Supreme Court.)
Authorization is:
Granted Denied
Signature: _________________________________________
Printed Name: ______________________________________ Date:
You have the right to seek review by filing written notice with the Chief Superior Judge (superior court) or
the Supreme Court (Supreme Court).
The applicant does not meet the definition of media
Other: