IHS Felix Morley Journalism Competition
Entry Form

APPLICATION DEADLINE: December 1, 1999

This application is formatted using to print directly from the WWW; you do not need to download this form to your hard drive. If you are using Netscape, print the application using the "print" command in the file menu. If you are using a browser other than Netscape, we recommend that you request a hard-copy of the application from IHS. Please submit your complete mailing address, and an application will be sent to you.

____ MR. ____ MS.

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(NAME)

BIRTH DATE _____________________
(MONTH/DAY/YEAR)

Social Security No. _____________________

CURRENT ADDRESS* ___________________________________________________________________

PHONE _________________________

EMAIL _________________________________

Address is good until _____________________
(MONTH/DAY/YEAR)

HOME OR PERMANENT ADDRESS* (if different from above) ___________________________________________________________________

PHONE _________________________

*Please notify IHS immediately of any change of address.


How did you hear about the competition? (If you first learned of it from a posted notice or an ad, please tell us where.)

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EDUCATIONAL BACKGROUND**

Please list past, current, and anticipated universities, degree earned or intended, etc.

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(College or University, Date Attended [From/To], Major Field, Degree [BA., Ph.D.], Date Rec'd or Expected)

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Do you plan to attend graduate school? _____________ Year ______________

School _____________________ Field of Study _____________________

**High school students: please list current high school and graduation date; indicate college intentions in space for graduate school information.


PROFESSIONAL HISTORY

If you are not a student, or you were employed full-time for more than three months during your student years, please list your professional/employment history. Include military service.

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(Firm or Organization, Location, Job Title, Dates)

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ACADEMIC HONORS

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COLLEGIATE EXTRACURRICULAR ACTIVITIES

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PUBLICATIONS

List significant published works that are not submitted with this entry.

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WRITING INTERESTS

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CAREER GOALS

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CERTIFICATION
I certify that all statements made in this application are correct.

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(Signature of Applicant, Date)

Submit entries to:
Morley Competition, Institute for Humane Studies at George Mason University,
3401 N. Fairfax Dr., Suite 440, Arlington, VA 22201-4432