The Carolinian

University of San Carlos

Official Student Publication

Application Form

Personal Data

Name: _____________________________________________
Date of Birth: ________________________________________
Gender: ____________________________________________
Course: _____________________________________________
2 x 2 picture
Year Level: __________________________________________
Nationality: __________________________________________
Religion: ____________________________________________
Mailing Address: ______________________________________
Provincial Address: ____________________________________
Phone Nos.: _________________________________________
Email Address: _______________________________________

Current Organizations

Outside the University Position Term Within the University Position Term

Educational Attainment

School Years Attended Degree Obtained

Journalism Related Awards and Achievements Date

(elementary, secondary and tertiary)

_____________________________________ ______________________________
_____________________________________ ______________________________
_____________________________________ ______________________________

Experiences / Training in Journalism. Give a description of your duties where applicable.

(elementary, secondary and tertiary)

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

Why do you want to become a writer?

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

What are your special writing interests? (Please Check)

News Opinion Filipino

Features Entertainment/Events Interview
Sports Photo Journalism Others: Please specify:
Editorial Literary ___________________
Desired Position. (Please Check)
Editor-in-Chief News Editor Layout Artist
Associate Editor Literary Editor
Feature Editor Sports Writer

Character References (3)

Name Position Contact No. / Email Address
______________________ ________________________ ________________________
______________________ ________________________ ________________________
______________________ ________________________ ________________________

I certify that, to the best of my knowledge, the answers to all questions above are true,
complete and correct.

Date: ___________________ Signature over printed name: _______________________