College of Mass Communication and Media Arts

Brian Hunt New York Studies Scholarship Application

For MCMA Students participating in the New York Studies Internship Program

Please type or print in black ink and return to the MCMA Dean’s Office (COMM 1012).
Deadline is January 30, 2009.

Student Information
Name:

Student 850 #:

Permanent/Home
Address (street
address, city, state, zip):

Local Address (street

address, city, state, zip):

Permanent/Home:
Phone #(s):
Local / cell:

E-mail address(es):

Academic Record

In Fall 2009 I will be a (check all __Radio-Television major

that apply): OR
__Journalism major

__Cinema & Photography major

GPA (Include overall SIUC GPA,

Major GPA and, if applicable, name
of previous college and GPA earned
there)
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Activities

Please describe your involvement in department, college, university and/or other

student activities since you began your college career, especially those that
demonstrate talent in your field of study. Be sure and include participation in
competitions, student work, internships, community service and relevant
employment and volunteer work. (Attach an additional page if needed.)

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Describe your career plans and aspirations as specifically as possible:

Reference

Please provide the name, phone number and email address of a faculty member
familiar with your work:

Applicant Agreement

In connection with this application, I grant members of the faculty and staff of the
College of Mass Communication and Media Arts permission to review my
personal and academic records. My waiver of legal privacy extends only to those
reviews necessary and proper in connection with the consideration of my
scholarship application. I hereby attest as the recipient of a scholarship, I
authorize appropriate news releases, including to the following newspaper:

Newspaper name and address:

________________________________________________________________

________________________________________________________________

Your signature: ______________________________________________

Date: _____________________
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