Park Center for Independent Media Internship Awards
2016 Independent Media Internship Application
(Application for PCIM approval)
Applications for the Independent Media Internships should include:
1) This completed application form.
2) A short (less than 350-word) essay on the importance of independent media outlets and / or institutions
that work toward greater media diversity and accountability.
3) Your resume.
Email this form, your essay and resume to Brandy Hawley at bhawley@ithaca.edu.
Please note: After official approval from PCIM and then your internship site, you'll be required to fill out an
Application for Credit, which will be emailed to you. The tuition fee for, Summer 2016 is $1,220 per credit.
One-time attendance at a Sexual Harassment Prevention session is required of students prior to enrolling for one's
first internship.
--------------------------------------------------------------------------------------------------------------------------------
Your name:

Student ID:

Permanent telephone number:

E-mail address

Major:

Minor:

Number of credit hours earned:

Grade Point Average:

Planned Semester and year of graduation:

Academic Advisor:
(Jeff Cohen is the Independent Media Internship Advisor).

The number of credit hours--1, 2 or 3-- that you want to earn from the internship:
(You will need to pay tuition for each credit hour).

The names of your top 3 internship site choices and reasons for the choices: