Student Journalism Program Application

General Information
First Name*
Last Name*
Birth Date*
Email*
Phone (cell)*
Phone (home or other)
Address*
Street Address Address Line 2 City State ZIP Code
Name of School*
Year In School*
- Freshman
- Sophomore
- Junior
- Senior
Student Essay
Why would you like to become a student journalist?*
Emergency Contact Information
Name of Contact*
Relationship to You*
Primary Phone*
Emergency Contact Address*
Street Address Address Line 2 City State ZIP Code
Voluntary Demographic Information
Gender
What is your race?
- American Indian or Alaska Native
- Asian
- Black or African American
- Hispanic or Latino
How did you hear about the program?

General Information