B4FA Media Fellowship Application Form

Which country are you applying for?*

Ghana
Nigeria
Uganda
Tanzania

Name*

(Given Name) & (Family Name)

FirstLast

Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Date of Birth*

mm/dd/yyyy

Gender*

Male
Female

Office and/or mobile telephone number*

(preferred contact no first)

Email*

Name of media organisation for which you work (if any)*

Job title (Reporter, editor, freelance etc)*

Please describe your role, and for how long you have worked in it *

Media qualifications*

Previous media experience (jobs, traineeships etc)*

Previous training courses taken (especially any science/ agricultural reporting courses)*

List your current areas of interest in reporting*

Please describe why you are interested in this Media Fellowship*

Please describe why you believe you are a strong candidate for this Media Fellowship*

Do you have the approval of your editor/producer etc to participate in this Fellowship for 6 months? *

Yes
No

Name and position of approver*

Please attach a letter of support*

Examples of previous work:*

All these pieces must be your own work – pieces found to have been copied will result in the disqualification of the candidate. Please submit up to 3 short pieces (up to 500 words each for print, or up to 3 minutes for audio/video) which you have produced in the last two years on an agricultural, scientific or technical issue. Please give a date and where the piece was printed or broadcast in each case. If you have NOT produced any agric, scientific or technical pieces in the last two years, please send us up to 2 examples of what you consider your best reporting on other issues, AND please write or record a NEW piece of up to 500 words or 3 minutes on an issue to do with agricultural, plant breeding or biotechnology currently in your country. Please copy and paste the text of your pieces in the boxes below, with their titles and when and where they were published. Alternatively, please attach them here, if your file is too big to upload on this form, contact us on the email address above

Work 2

Work 3

Upload your work

Preferably as a zip file

Upload your work 2

Upload your work 3

Please list any experience you have of either farming or scientific research (if any) – eg former work, family engagement in these activity, experience from childhood etc.*

If successful, are you able to commit to attending the mandatory training course and engaging with the Fellowship opportunities over the six month period?*

Yes

B4FA Media Fellowship Application Form

Online Form