THE UNIVERSITY OF HONG KONG

JOURNALISM AND MEDIA STUDIES CENTRE

JMSC Media Internship Fund 2009-2010

Application Form

Application deadline: 5:30pm, July 31, 2010 (summer internship)

Key notes:
 All BJ students taking part in the “JMSC Media Internship Programme 2009-2010” are eligible to apply.
 Students must submit this application form with relevant supporting documents.
 Successful applicants must submit receipts of all expenses such as air tickets, lodging, transportation, meal and
others as requested (if applicable), together with samples of work from the internship, a report on the experience
and an evaluation form after the internship.
 Successful applicants may be invited to attend and/or to give presentations and/or to describe internship
experiences at ceremonies and/or other events.
 Awards are based on financial needs, academic achievement and participation in extra-curricular activities. The
amount will vary according to individual situations. Priority will be given to students with financial needs who
have not previously won internship scholarships.

Please type or use BLOCK letters.

SECTION A – PERSONAL PARTICULARS

Name in English (surname first): Name in Chinese (if applicable):

HKID No. / Passport No. Date of Birth: Sex:

Mobile Phone No.: Home Telephone No.: E-mail Address:

Correspondence Address:

University No.: Current Year of Study:

SECTION B – ACADEMIC RECORD

Year 1 GPA 1st Semester: 2nd Semester: CGPA:
Year 2 GPA 1 Semester:
st
2nd Semester: CGPA:
SECTION C – AWARDS / SCHOLARSHIPS (in the past 2 years)
Awards / Scholarships Issuing Authority Nature of Awards / Scholarships Date
(eg. Sports, Academic, etc.)
1
SECTION D – EXTRA-CURRCULAR ACTIVITIES / COMMUNITY SERVICES (in past 2 years)
Name of Organization Position Held Nature of Work Date

SECTION E – FINANCIAL NEEDS DECLARATION (please attach relevant supporting documents)

a) Government Grant & Loan Scheme in 2008/2009
Have you applied?
Yes Amount of Grant: $ Amount of Loan: $
(please attach the Notification of Results of Application for Financial Assistance under the LSFS)
No Reasons:

b) Non-Means Tested Loan Scheme in 2008/2009

Have you applied?
Yes Amount of Loan: $
No Reasons:

c) Other Financial Assistance (e.g. Bursary, Emergency Fund, Special Loan) Received in 2008/2009
Name of Financial Assistance:
Amount: $

d) Additional Information on Financial Situation:

SECTION F – INTERNSHIP DETAILS

Local / Mainland China / Overseas Internship (please circle) Print / Broadcast / Online (please circle)
Country: Company:
City: Position:
Salary/Allowance: Period:
Duties:

SECTION G – STATEMENT OF UNDERSTANDING

1. I understand that the Journalism and Media Studies Centre reserves the right to discard my application if any
section of this form is incomplete or the supporting document(s) is/are not submitted with this form before the
application deadline.

2. I declare that the information given here is correct and I agree to abide by the rules and requirements of the
Journalism and Media Studies Centre.

Date: Signature:
2
I attach (please tick) a copy of following document(s) in support of my application:

 Notification of Results of Application for Financial Assistance under the LSFS

 Others _____________________________________________________________________________________

* All information will be kept in confidence and used according to the university policy on Personal Data Protection.

Completed application form and supporting documents should reach

Programme Officer (BJ)
Journalism and Media Studies Centre
G24, Eliot Hall
The University of Hong Kong before the application deadline.