East Africa Regional Story Grant - Application Form
INSTRUCTIONS:
This is a lengthy application form. You are requested to dedicate between 15 and 30 minutes to it. You may find it useful to print the form to familiarise yourself with it before filling it in.

Provide ALL information. The more detailed your application is, the higher your chances of selection for a grant. Incomplete forms with unanswered or partially answered questions will not be considered at all.

BIO DATA
First name *
Last name *
Gender *
CONTACT INFORMATION
Primary email address *
Primary phone number *
Alternate phone number
Name, address and phone number of the media house for which you primarily work *
What is your current position in the media house named above? *
EDITORIAL OVERSIGHT
Name of your editorial supervisor *
Position and title of your editorial supervisor *
Editorial supervisor's phone number *
Editorial supervisor's email address *
Next
Never submit passwords through Google Forms.
This form was created inside of African Centre for Media Excellence. - Terms of Service - Additional Terms