2015 Peace Sullivan/James Ansin High School Workshop in Journalism and New Media

A P PLI C AT ION (2 PAGES)

School of Communication at the University of Miami in Coral Gables, Florida th th Workshop dates are Sunday, July 5 – Saturday, July 25 , 2015. Please legibly print or type application (Application deadline is May 5, 2015) PERSO NAL IN FORM ATIO N

Name: Address (include apartment number, city, state, ZIP code):_

Home phone: ( em Date of birth:_ ail )- :

Gender: Male Female Grade point Current grade in school: 10 11 12 average:

S CHOO L INFORMATIO N

School name:

School address (include city & ZIP code)

School telephone (include Journalism extension):

Journalism or TV Production Adviser (and contact information):_ School or TV publication / Web or Internet activities:_

**PLEASE ENCLOSE YOUR TWO BEST CLIPS OR CDs OF STORIES, LAYOUTS, PHOTOGRAPHS, VIDEOS, AND WEB DESIGNS FROM THE SCHOOL NEWSPAPER, YEARBOOK, WEBSITE OR OTHER PUBLICATION OR MEDIA.

Indicate what kind of experience you may have in desktop publishing:

Indicate what kind of experience you may have in web design, video, video blogging, TV production: WORKS HO P IN FOR MATIO N From this list, what workshop positions most interest you? (Reporting/writing, editing/headlines, layout, computer page design, photography, web page design, video)

1st choice:

2nd choice_

Do you plan to attend any other journalism workshops? If yes, please identify:______

Have you ever attended a summer journalism workshop before? Please identify. ______

ON A SEPARATE SHEET, WRITE A 200-WORD ESSAY TO EXPRESS YOUR INTEREST IN JOURNALISM.

------Pa renta l Approv al Parent or guardian must sign this permission:

I give permission for my son or daughter to attend all sessions of this high school journalism workshop at the School of Communication at the University of Miami and at other sites (as reporting projects may require) in Miami-Dade, Broward and Palm Beach counties. I will provide transportation to and from the Coral Gables campus when necessary. My son or daughter has my permission to participate in any field trips that are organized by the workshop staff. My son or daughter also has permission to spend the required nights during the workshop in University of Miami dormitories. I understand that the University of Miami assumes no liability for personal injuries during the workshop period. I also understand that if my child is accepted, we may be required to complete additional forms and provide additional information as a condition of his or her participation in the program.

PRINT NAME:

SIGNATURE:

Contact Information for Parent or Guardian (e.g., any cell, work and home phone; email address or other address):______

______

Tea cher Reco mmen da tio n Please include one letter of recommendation from a teacher, counselor or adviser who is familiar with your skills and character. (Please note that if this letter is missing, we may decline to consider your application)

------Return this form with clips, essay and teacher recommendation to:

Samuel A. Terilli (NOTE: Applications & materials may be sent by mail, hand-delivered or scanned & emailed) Co-Director High School Journalism Workshop School of Communication University of Miami 5100 Brunson Dr. Coral Gables, FL 33146 (305)-284-8451; [email protected] APPLIC A TI O N DE A DLINE IS May 5, 2015