The World Affairs Journalism Fellowships

Application deadline: June 10, 2009

Program for which you are applying

Full Name:

First Name

Last Name

Date of Birth

Country of Birth

Desired Destination

Brief Project Description (2-3 sentences):

Desired Duration of Overseas Trip (1-2 weeks): *

Desired Start Date

How did you hear about the program?

Personal Data

Current Employer

Current Position

Primary Address

Street

City

State/Province

Zip/Postal Code

Primary Phone Number

Primary Fax

Primary E-mail

Secondary Address

Street

City

State/Province

Zip/Postal Code

Secondary E-mail

Mobile Phone

Health (Do you have any health condition or dietary needs that could be a factor during an extended stay abroad?)

Professional Skills

Section V: Languages

Please score yourself in language proficiency, other than English, using the following scale:

1. Elementary Proficiency-Able to satisfy routine travel needs and minimum courtesy requirements

2. Limited Working Proficiency-Able to satisfy routine social demands and limited work requirements

3. Minimum Professional Proficiency-Able to use language with sufficient structural accuracy and vocabulary to participate effectively in most conversations on practical, social and professional topics

4. Full Professional Proficiency-Able to use the language fluently and accurately on all levels pertinent to professional needs

5. Native or Bilingual Proficiency-Equivalent to that of an educated native speaker

Language

Speaking

Reading

Language

Speaking

Reading

Language

Speaking

Reading

International Experience

Briefly list any overseas work or travel you have completed in the past 10 years.

Briefly elaborate on your professional skills indicated above and how they would be applicable to meeting the goals of this fellowship.

Reasons for Applying

In no more than 750 words, please explain your reasons for applying for this particular fellowship at this time.

Curriculum Vitae

Please attach a resume detailing your professional experience and educational background.

Please attach a description of no more than 800 words of your project proposal. (See guidelines for project proposal on the fellowship information guide.) *

Professional Recommendations

Applicants for this fellowship are required to have three confidential letters of recommendation sent to the application committee. The letters should comment on the applicant’s journalistic, media or training qualifications as well as his/her suitability for an oversees assignment. Please have the recommenders send their letters directly to ICFJ via fax: 202-737-0530, e-mail: wajf@icfj.org or post: WAJF, c/o ICFJ, 1616 H St. NW, 3rd Fl., Washington, D.C. 20006. Please include contact information below.

Author One

Name

Position

Affiliation

Contact Information

Author Two

Name

Position

Affiliation

Contact Information

Author Three

Name

Position

Affiliation

Contact Information

Self-Identification (Optional)

ICFJ is committed to equal opportunity. For informational purposes only, you are invited to identify yourself in certain categories. Please note that you are under no obligation to complete this section. The information or decision not to provide information in this section will not be used as a factor in considering your application.

Sex MaleFemale

Statement of Understanding

Applicants are required to complete the statement of understanding

I, the undersigned, understand and agree that the International Center for Journalists (ICFJ), as program administrator, is under no obligation to select me or any other applicant for the World Affairs Fellowship Program. If selected to be a World Affairs Fellow, I will agree to the premises and conditions set forth in the following statement:

1. As a precondition for participation, I agree to: - take part in the group orientation in Washington from August 30 to September 4, 2009 and complete a fellowship expense report within two weeks of returning from my overseas fellowship. My fellowship will take place between mid-September to December 31, 2009 and articles based on my reporting through the fellowship will be published or broadcast by February 1, 2010.

2. I understand that the program administrator may terminate my fellowship at any time for reasons that are regarded as detrimental to the fellowship, to be determined at the sole discretion of the program administrator or sponsor.

3. I will be responsible for my own passport and visa arrangements and may be asked to assist with other logistical arrangements related to my specific assignment as determined by the program administrator.

Signature

Date