AL NEUHARTH FREE SPIRIT AND JOURNALISM CONFERENCE

A journalism workshop at the Newseum in Washington, D.C., July 14-19, 2012,
to inspire and prepare free-spirited rising high school seniors for media careers.

2012 PROGRAM APPLICATION
To qualify as an applicant for this program:
  1. You must be a high school junior who will graduate in the Class of 2013.
  2. You must be committed to pursuing a career in journalism.
  3. You must demonstrate qualities of a "free spirit."
  4. You must be available to attend the conference July 14-19, 2012.
To apply, you must follow these steps:
  1. TYPE the required information in the boxes below.
  2. SUBMIT electronically for our applicants' database.
  3. PRINT OUT the completed application form.
  4. MAIL this completed application form (signed by you, your parent/guardian and school official) with all the necessary documents and materials including two essays, two sealed letters of recommendation, high school transcript, samples of your journalistic work and a 4x6 headshot photo.

For more information about this program visit www.freedomforum.org/freespirit

BIOGRAPHICAL INFORMATION
First Name
Middle Name
Last Name
Preferred Name
Birth Date
(mm/dd/year)
Gender
Home Address
City
State
Zip
Cell/Home Phone
E-mail
 
Ethnic Background (Optional)
Other (specify)
 

PARENT OR GUARDIAN INFORMATION
Mother's Name
Mother's Primary Phone (111-111-1111)
Father's Name
Father's Primary Phone (111-111-1111)
Guardian's Name
Guardian's Primary Phone (111-111-1111)
 
 

ACADEMIC INFORMATION

The following questions pertain to your academic background. If your school does not have a GPA system, please estimate your current GPA on a 4.0 scale.
Type of School
Grade Point Average
Breakdown of SAT/ACT Scores (if available)
School Name
School Address
City
State
Zip
School Phone (111-111-1111)
School Fax Number (111-111-1111)
Principal's Name
Principal's E-mail
Guidance Counselor's Name
Guidance Counselor's E-mail
School website (if applicable)
Journalism Advisor's Name
Journalism Advisor's E-mail
School Newspaper Name
School Newspaper website (if applicable)
Month/Year of Graduation (must be in 2013)
  /2013
 
College/University You Are Considering
(List your top three in order of priority -- do not abbreviate university names)
1.
2.
3.
 
What type of media organizations would you like to work for after you graduate college?
Others (please specify)
  
 

ACTIVITIES/COMMUNITY SERVICE/AWARDS
 
List Top Three Extracurricular Activities (400-character max)
1.
2.
3.
 
List Top Three Community Service or Volunteer Activities (400-character max)
1.
2.
3.
 
List of Awards or Honors Received in High School (400-character max)
1.
2.
3.
  

PROGRAM SURVEY
How did you learn about this program?
Other
 

IN THE NEXT PART OF THE APPLICATION, THE FOLLOWING MATERIALS AND DOCUMENTS MUST BE PRODUCED AND MAILED WITH THE PRINTED APPLICATION.

  1. ESSAYS

    Both essays must be typed and signed/dated by BOTH the applicant and the journalism/media advisor, principal, teacher or counselor.

    Essay One:  Write an essay explaining why you want to pursue a career in journalism. (Maximum of 500 words)

    Essay Two:  Write an essay about your specific qualities as a free spirit. Explain your experiences and/or struggles that make you a free spirit. Possible characteristics include leadership, courage, creativity, risk-taking, fearlessness, innovative thinking, perseverance, rising above circumstances to accomplish something extraordinary.  (Maximum of 500 words)
 
  1. TRANSCRIPT
    An official transcript must be submitted with this application.
 
  1. LETTERS OF RECOMMENDATION
    Two letters of recommendation must be submitted from the journalism/media advisor, principal, counselor, teacher or other mentor. The letters should describe why this student is nominated for the Al Neuharth Free Spirit Scholarship and Journalism Conference. Describe the applicant's personal qualities, his/her commitment to pursuing a career in journalism and characteristics that make him/her a free spirit.  Person recommending must be familiar with the applicant's work and personal characteristics.  The letters should be placed in sealed envelopes and submitted with this application.
 
  1. JOURNALISTIC WORK 
    Applicant must submit at least three samples of his/her work related to journalism. Work may include any of the following (work samples will not be returned):
    • Byline printed article
    • Online content (printed format)
    • Classroom journalism assignment
    • DVD - must have label with applicant's name, state and brief description of the broadcast with date. 
    • Videotape - must have label with applicant's name, state and brief description of the broadcast with date.
    • Audiotape - must have label with applicant's name, state and brief description of the broadcast with date.
    • Byline photo
    • Yearbook pages
 
  1. PHOTOGRAPH
    A recent color 4x6 head shot must be stapled to the upper right-hand corner of the application form with complete name and state written on the back of the photo. Please place the staple at the very top of the photo and not on the image.
 
  1. SIGNED APPLICATION
    Once you have completed the application and printed it out, it must have the following three signatures.
Applicant Signature
In submitting these materials, I certify that all of the information submitted in support of my application is complete and accurate to the best of my knowledge. False information will result in termination of the scholarship if granted.

 

(Student's Signature)                                                    (Date)

Parent/Guardian Approval
I certify that the information provided by the applicant is complete and accurate to the best of my knowledge.

 

(Parent/Guardian Signature)                                         (Date)

School Official Certification
I certify that the information provided by the applicant is accurate to the best of my knowledge.  This student is in good standing with the school.

 

(Principal or Guidance Counselor's Signature)              (Date)

 
 

COMPLETED APPLICATION
Please check the boxes below to make sure that you include ALL the required materials before you mail your application.

PLEASE MAIL COMPLETE APPLICATION MATERIALS
IN ONE 9X12 ENVELOPE TO:
Freedom Forum
Attention:  Al Neuharth Free Spirit and Journalism Conference Program
555 Pennsylvania Ave. N.W.
Washington, DC  20001
 
AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED.
 
APPLICANTS MUST BE AVAILABLE TO ATTEND THE ENTIRE CONFERENCE, JULY 14-19, 2012
 
If you have any questions, please send an e-mail to
freespirit@freedomforum.org or call Karen Catone at 202/292-6271.
 
The Freedom Forum makes all 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.