Application form

Please fill in the information below as completely and accurately as possible.

Personal Information

First Name *

MI *

Last Name *

Address *

City *

Province

Postal Code

Phone *

Fax

Email Address *

Date of Birth * +

Gender *

Male

Female

Professional Information

Name of Media Organization or Blog *

Position *

Years in Journalism *

Office Address *

City *

Province

Postal Code

Office Phone *

Office Fax

Office Email Address *

Sample Work*

Please submit two bylined articles. For print and online journalists, upload stories or provide links of published stories. For broadcast journalists, provide links to audio or video productions or samples in compressed format via wetransfer.com, Dropbox or Google Drive. File size should not exceed 250mb.

Upload File

URLs (Click the + sign to add more links)

Updated CV *

Story Proposals

Please give three story ideas you plan to work on during the fellowship. Briefly describe the storyline and state why the story is interesting or relevant. Provide initial list of interviewees or news sources. Summarize each proposal in 150-200 words.

Story Proposal 1 (150 to 200 words) *

0/200 words

Story Proposal 2 (150 to 200 words) *

0/200 words

Story Proposal 3 (150 to 200 words) *

0/200 words

Endorsement Letter from Editor/Producer/Supervisor *

I attest to the veracity of the information provided on this form.

Type Your Legal Name *

Date Submitted * +

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