Chips Quinn Scholars Program for Diversity in Journalism
A program that offers training, mentoring, paid internships and cash awards to college
students or recent graduates who are pursuing in careers in the media


  

Please use the Windows Internet Explorer to process the online application (this form).
If you experience any technical difficulties in completing this online application form,
please contact Brian Lee at blee@freedomforum.org

To qualify as an applicant for this program:
1) You must be committed to pursuing a career in journalism
2) You must be a college junior, senior or recent graduate
3) You must be able to attend the nine-day, all-expense-paid training in Nashville, Tenn.
4) You must be a US citizen or permanent U.S. resident
5) Cars are mandatory for the majority of internships offered through our program. If you cannot provide a car, please know that it will limit significantly your placement opportunities.

To apply, you must follow these steps:
Type the required information in the boxes below
Submit electronically for our application's database
Print out the completed application form
Mail this completed application form along with any documentation that is necessary and that you are unable to submit electronically

For more information about this program visit www.diversityinstitute.org

Please indicate which program you are applying for.
Spring (Jan. - April)
Summer (May - Aug.)

BIOGRAPHICAL INFORMATION
First/Middle/Last Name
Preferred Name
Birthdate (mm/dd/yyyy)
Gender
College or University
Address1 (while at school)
Address2 (while at school)
City/State/Zip
Cell Phone/Home Phone
E-mail address
Ethnic Background Other(specify)
Your hometown - City/State/Zipcode
Do you have a valid drivers license? If not, can you get one by the start of your internship?
Can you provide a car during your internship?
Are you a U.S. citizen?  Other(specify)  
In addition to English, are you fluent in any other languages?               
 Language1 Capability:               
Language2
 Capability:   

PARENT OR GUARDIAN INFORMATION
Parents Name
Address
City/State/Zip
Primary Phone (111-111-1111)
Please click on 'Save Data' before moving on to the next line. By doing so, the system will check the data you have provided so far. In addition, you can revisit the form at a later date/time if you prefer to do so.

ACADEMIC INFORMATION
Name of College or University 
Year you are currently in college  Other(specify)
Major/Minor    
Overall GPA Journalism GPA
Expected graduation date: mm/dd/year

PROFESSIONAL EXPERIENCE
Please list all professional journalism internships:
    Company                  Dates             Duties
Honors, awards, scholarships, etc
Scholastic journalism (check any that apply)

Area(s) of interest for the internship: Copy editor (in news or sports), graphic designer, online, multimedia producer, photographer, reporter (business, city, features, sports).  (Please list in order of preference) 

Do you have any disabilities that may require special accommodation on the part of the host newsroom in order for you to function efficiently? If yes, please elaborate

If given a choice, please list the region of the country, in order of preference, that you would prefer to work in (i.e. East, West, Southeast, Southwest, Northwest, Midwest
If family or other obligations impose geographic limitations, please be specific about your geographic needs

If selected, what do you hope to gain from and contribute to your internship newsroom?
Three years from now I want to be: 
I have read all of the information pertaining to the internship program. If accepted by the Chips Quinn Scholars program, I agree to honor my commitment to complete the orientation program and the 10- or 12-week internship that follows except if I become medically disabled. All of the information I have given in this application and the attached materials is correct. If selected, I also agree that the Chips Quinn Scholars program can use my statements and likeness in its promotional literature.
Please note: Chips Quinn interns are required to comply with personnel policies and practices at their internship sites, which may include drug testing.
Applicant’s e-signature (Please type your name)
Date: (mm/dd/yyyy)
 
 You can save the data, and revisit the form later by clicking on 'Save Data' anytime.
PROGRAM SURVEY
How did you learn about this program? 
THE FOLLOWING MATERIALS AND DOCUMENTS MUST BE SCANNED AND ATTACHED, OR MAILED WITH A COPY OF THE PRINTED APPLICATION.
ESSAY
Please explain why you want to be a Chips Quinn Scholar/journalist. This statement (200 – 400 words) should illustrate your writing ability, discuss your views on journalism as a career and provide any additional information you think may be helpful.
Upload your 'ESSAY' on e-file format such as word, pdf.   

View uploaded Essay [Hlink_essay]
TRANSCRIPT
Please submit a copy of your academic transcript (unofficial transcript is acceptable)
Upload your 'Transcript' if available on e-file format such as word, pdf.

View uploaded transcript [Hlink_transcript]
LETTERS OF RECOMMENDATION
Two letters of recommendation must be submitted from the journalism/media adviser, professor or other mentor. The letters should describe the applicant’s personal qualities and his/her commitment to pursuing a career in journalism. Persons recommending must be familiar with the applicant’s work and personal characteristics.
If available, please upload copies of your letters of recommendation here. Please note that letters of recommendation can be sent under separate cover. They can either be mailed to Karen Catone at the Washington, D.C. address – or they can be e-mailed to Karen Catone at kcatone@freedomforum.org

View uploaded letter1  [Hlink_letter_recom]  


View uploaded letter2 [Hlink_letter_recom2]
JOURNALISTIC WORK
Applicants must submit six work samples. 
Please mail all work samples (as outlined below) to: Chips Quinn Scholars program, 555 Pennsylvania Ave., NW, Washington, DC 20001.
Reporters: Clear photocopies of published articles on 8 ½ by 11” single-sided paper. Do not copy stories on both sides of the paper and do not reduce size of print. If stories are oversized, use 8 ½ by 14” paper or send a tearsheet. Class assignments are accepted but must be typed. Do not use folders or binders in submitting your package.
Photographers who are providing portfolios are encouraged to submit their work on a CD (and mailed to the address provided above).
Multimedia journalists are encouraged to submit their work samples on a CD (and mailed to the address provided above).

PHOTOGRAPH
A recent color 4x6 head shot.
    
View uploaded Photograph [Hlink_photo]
RESUME
      
View uploaded Resume [Hlink_resume]


COMPLETED APPLICATION
Please check the boxes below to make sure that you include ALL of the required materials before you submit your application.
Clicking the 'submit' button, you can review the information before finalizing the process.
 
 
 
 
 
 
 


If you are able to complete this application form online AND include all of the required documentation electronically, it is NOT necessary for you to print out this application and submit it via the U.S. Postal Service. (Please note that letters of recommendation MAY be submitted under separate cover -- via U.S. Postal Service or via e-mail to kcatone@freedomforum.org)

If you are UNABLE to complete this application and include all of the required documentation electronically, please mail a completed application form and all of the necessary components to:
Karen Catone
Director/Chips Quinn Scholar program
Freedom Forum Diversity Institute
555 Pennsylvania Avenue, NW
Washington, D.C. 20001

An incomplete application will not be considered.

Application deadline: Oct. 15, 2011
We will accept applications after the Oct. 15 deadline -- but students who are able to meet the deadline will be considered ahead of late entries.

If you have any questions, please contact Karen Catone,  program director,  at
kcatone@freedomforum.org or call 202-292-6271.
The Freedom Forum Diversity Institute makes all scholarship determinations without regard to race, color, religion, sex, national origin, age, disability or any other protected classification.
PLEASE REVIEW ALL INFORMATION BEFORE CLICKING “SUBMIT”. YOU CANNOT MAKE CHANGES ONLINE AFTER SUBMISSION.