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Scholarship Fund Application Form
Gre International Chapter Scholarship Fund
Society of Professional Journalists/Sigma Delta Chi
me_____________________________________________________________________________
Permanent Home Address'--___________________________________________________________
Telephone__________________________________________________________________________
School Address'--_____________________________________________________________________
Telephone _________________________________________________________________________
STUDENT APPLICATION
Collegev .-___________________________________________________________________________
Next year I will be: Junior
Senior
Graclu._______________________________________
Grade Point Average in your major_______________________________________________________
Overall
_____________________________________________________________________
Journalism Course:;.
s ___________________________________________________________________
Journalism Organizations, Memberships=>-_____________________________________________________
GPA~
Journalism Experience_________________________________________________________________
Professional Goals ___________________________________________________________________
Financial Assistance (specify source of tu ition, other costs and total costs)_____________________________
PROFESSIONAL APPLICATION (Answer only if you are a working journalist)
Employer_________________________________________________________________________
Years in Profession__________________________________________________________________
Present Position, Responsibil ities'-_________________________________________________________
Degrees, Advanced Training (include year of graduation),_________________________________________
Professional memberships/recognition'-_____________________________________________________
Professional Goals ___________________________________________________________________
Plans for Use of Scholarship Including Status of Admission, College _______________________________
Current Education -
Related Debt; Financial Resources Available and Other Assistance_ _ _ _ _ _ _ ___
Signature___________________________________________________________________________
Date_____________________________________________________________________________
Return by April 30 to Annemarie Franczyk, secretary, 858 Fillmore Avenue, Buffalo, N.Y. 14212
(Please submit a 250-word statement as explained in the rules.)
Society of Professional Journalists
Financial information supplement
Expenses
Tuition
-------------------------------------------
Room and Board (if applicable) ___________________________
Books
-------------------------------------------
Other expenses and/or obligations (please specify) _ _ __ _ _ _ __
Totale~nses:
_ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ ___
Income and assistance
Scholarships _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ __
Loans
- - - - - -- -- - - - - - - - -- - - - - - Paid internships _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Jobs (please specify) _ _ _ _ _ __ _ _ _ _ _ _ _ _ __
Parental contributions
- - - - - - - - -- - - - - - - Personal savings _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ __
Other (please specify) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Total income and assistance
- - - - - - - - - - - -- - - -
Employment data
Current employer _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ __
Date hired
Job title
- - - - - - - - - - - - -- - - - - - - - - -
----------~-----------
If less than one year, list previous employer _ _ _ _ _ _ _ _ _ __ _
)gg590)0304
SPJApplication.pdf (PDF, 820.19 KB)
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