SPJApplication .pdf

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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


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