Bursary application form: project-based training workshop series

Please submit this application form, together with a brief motivation
letter outlining why you would like to attend the investigative
training workshop series. The application must be signed and supported
by the Editor and/or station manager as well as a signed commitment to
attend the entire series. Preference will be given to community
reporters.

I ………………………………………………………., would hereby like to apply for a bursary to attend the Investigative Journalism Conference.
I require support with:
□ Transport (Please note that reimbursement will only be provided on receipt of the original bus or taxi tickets and by electronic transfer – please provide your bank details below)

□ Accommodation – Dates: From ……………………… to …………………………
(46 High Street • Berea • Johannesburg • P.O. Box 87562 • Houghton • 2041
Tel: (011) 642-4811 • Fax: (011) 642-4866 • Web: www.staycity.co.za)

Banking details for reimbursement of transport costs:
Name of Bank ……………………………………………

Name of Account ……………………………………………

Type of Account……………………………………………..

Account Number……………………………………………..

Branch Number………………………………………………

I confirm that the information supplied is correct:

APPLICANT’S NAME ……………………………………………………………

APPLICANT’S SIGNATURE……………………………………………………..

I support this application for a bursary:

MANAGER’S NAME AND POSITION………………………………………………….

MANAGER’S SIGNATURE………………………………………………………………

Return to: Investigative Journalism Workshop
Address: Wits Journalism
Private Bag 3
Wits 2050
Email: sibongile.msimanga@wits.ac.za
Fax: 011-717 4694