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Asian College of Journalism Postgraduate Journalism Programme 2010-2011 Application Form
	Instructions: Please ensure that all the items in the form are filled in. Please do not send any original documents or photocopies with this application. If admitted, you will be required to produce originals of the relevant documents. Please send TWO passport size photographs and a DD in favour of "Media Development Foundation", payable at Chennai for Rs. 1000/- (Rupees One Thousand Only) to: Asian College Of Journalism Second Main Road (Behind M.S Swaminathan Research Foundation) Taramani Chennai-600113 Tel: 91-44-22542840 / 22542842 - 47



Name	:	Mr. Ms.
		First Middle Last

Date of Birth	:

Address for Communication	:

Telephone	:

Fax	:

E-mail	:



Name of Father/Guardian	:

Occupation	:

Home Address	:

Tel	:

E-mail	:

Office Address	:

Tel	:

Fax	:

E-mail	:



Mother's Name	:

Occupation	:

Home Address	:

Tel	:

E-mail	:

Office Address	:

Tel	:

Fax	:

E-mail	:



Annual family income from all sources	:	Rs. (in words)

Do you intend to apply for full or partial scholarship?	:	Yes No (If yes, please attach proof of family income. For Dalit/Adivasi scholarship please also attach the community certificate)

Education (Start with last College/University attended)

Institution	Year	Subjects	Degree	Marks/Grades Obtained
				%
				%
				%

High School	Year	CBSE, ICSE, Matriculation, Other	Marks Obtained
			%
			%

Other education qualifications (computers, languages, cultural, music education, etc.)

Institution	Year	Subject	Certificate	Award

Academic distinctions/awards, if any	:

Extracurricular interests, hobbies, sports, etc.	:

Office/Computer Skills Rate your competence in the following:
	Very Competent	Moderately Competent	Not at all Competent
Touch Typing
Shorthand
MS Word
Excel
Internet
E-mail
Browsing
Chatting
Others (Specify)
Note: These skills are not prerequisites for admission

Work experience, if any (including part-time)

Organisation	Year	Title	Responsibilities

Indicate your stream option	:	Print Television Radio New Media
Indicate your second and third option	:	Option2:	Option3:
Indicate your second and third option

Describe in 50 words the abilities and talents you think you should have to succeed in your chosen stream:





List the newspapers / magazines you read regularly	:	Publication	Frequency




List the television programmes you watch regularly	:	Programme	Frequency

Name three leading professionals in your chosen stream and explain, in a sentence or two, why they have impressed you:

Describe in 50 words what you understand by New Media, listing some web-sites which have impressed you:

Describe in 50 words how you see radio FM broadcasting developing in India:

Has any of your work been published? If yes, specify:

Tell us in 100 words why you wish to be a journalist and why you think you will be good at it:

Indicate your preference for an examination centre	:

Will you need rental accommodation in Chennai? (Residential accommodation on the ACJ campus on room sharing basis and food are together expected to cost Rs 75,000 for 10 months)	:	Yes No



Verification and Submission Click on "View your Data" to verify the details you have filled in. Click on "Submit" once you have verified your details. Submit only once....Please wait while the form is being submitted. Click on "Reset" to discard all the data in the form.


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	Asian College of Journalism, Second Main Road, (Behind M.S Swaminathan Research Foundation) Taramani, Chennai-600113 Tel: 91-44-22542840 / 22542842 - 47 Fax: 91-44-22542839 Email: asian_media@vsnl.com