Russia-U.S. Young Media Professionals Program

Application due by June 21, 2015

Please fill in all personal data in English exactly as it appears on your valid international passport

Your international passport must be valid for at least six months after the end of the program (21 August 2015). If you plan to apply to the program and do not have a valid international passport, please obtain one as soon as possible. Please respond to all of the questions.

I. Personal Information




























Do you use Facebook, LinkedIn, Twitter, or any other social networks? If so, please tell us how to find you.







II. Professional and Personal Goals





III. English Language Skills

Please tell us about your English proficiency.

Interview:

Please keep in mind that ICFJ may contact you by telephone or social media for a brief interview in English.

IV. Employment Experience
Please list your past employment experience starting with the most recent.















V. International Experience




VI. Education

VII. Goals and Interests

VIII. References
Please provide two references. Your references can be past or present employers, teachers or someone else who can speak about you and you qualifications for the program.
Reference 1




Reference 2




IX. Supporting Documents


X. Agreement to Program Conditions

I, the undersigned, understand and agree to the following conditions of the “Russia-U.S. Young Media Professionals Program”:

 

1. If I am chosen to participate, I will be required to take part in a program in the United States from 3 to 21 August 2015, which will include a two-week internship at a U.S. media organization.

 

2. I fully understand and agree that it is a condition of this program that spouses or dependents cannot be included nor be accommodated in the program.

 

3. The program’s organizers will pay all travel costs; housing; a per-day meal/living allowance; visa costs; and health insurance for the duration of the program in the United States. I will assume responsibility for all incidental expenses. (The program cannot cover salary or pay honoraria.)

 

4. If chosen, I am required to return to my home country after the program ends.

 

5. If I extend my stay in the United States before or beyond the program, I agree to pay the cost of all expenses (food, lodging, transportation, etc.), including the extension of my insurance policy.

 

My participation in this program depends upon my ability to meet all requirements. I certify that all statements in my application are true to the best of my knowledge. I understand that any participant who violates these rules will be expelled from the program.

 

Please type your name and today's date in the boxes below. This will serve as an electronic signature and is your written consent to the above conditions.



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