FELLOWSHIP PROGRAMME – 2015-16
Fellowship Programme For the Journalist of Tomorrow.
Application Form. (To be filled in bold capital letters only)

Fields mark with * are mandatory.
NAME IN FULL*
RESI. ADDRESS
DATE OF BIRTH*
ACADEMIC QUALIFICATIONS*
DETAILS OF EXAM. PERFORMANCE : (Mention secured in the boxes given)*
Qulification Year of passing Class / %
SSC
HSC
Diploma/Degree
Add Any Other Below
For Students of Journalism Name of College / Institution :
Address :
Title of the Degree / Diploma course :
For Students of Journalism : Details of the noteworthy Co-curricular performance, if any. (Such as Debate / Elocution / Drawing / Photography / Essay Writing / Journalistic writing and others)
FOR ALL OTHERS Profession, if any :
Name and address of the employer :
Annual Income Rs. :
Please mention any two topics as per your order of preference on which you would like to work.
Reference (Mention names, addresses and telephone numbers of two persons, who are in public life and who can tell us about your abilities and motivations.