Application for Scholarship GIJC 2011 by HC111205045419

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									Application for Scholarship GIJC 2011

 Signature                                                    Date dd/mm/yyyy


 Full name (as in passport):


 Born at dd/mm/yyyy       in      town                    country

 Passport number:                   Date of issue dd/mm/yyyy Date of expire dd/mm/yyyy


 Issued by:


 Education



 Present employer / freelance


 Experience as investigative reporter / editor. References.




 Budget in EUR

 Visa……………………………………………………..
 Transportation in home country…………………………
 Flight…………………………………………………….
 Participation fee…………………………………………
 Accomodation……………………………………………
 Per diems………………………………………………..
 Total costs...……………………………………………..
 Own contribution……………………………………….
 Scholarship GIJC……………………………………….

								
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