Application Form

PLEASE NOTE: The applicant must be a United States citizen and the applicant’s school must be in the United States. (U.S. citizens attending U.S. government schools outside of the U.S. may apply.)

Student/Applicant

Name:

Email:

Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Age:

Year in School:

(Sophomore, Junior, Graduate Student, etc.)

Anticipated Graduation Date:

Are you a citizen of the United States?
YesNo

School

Name:

Address:

City:

State:

Zip:

Is your school located in the United States?
YesNo

Where did you hear about the Foundation? (Give specifics if possible.)

Acknowledgment:

I give my permission for the information contained in this application to be reviewed by the Selection Committee and Board of Directors of The James Alan Cox Foundation for Student Photojournalists. I also grant permission to the Selection Committee and Board to obtain all other information necessary for determination of my eligibility for this scholarship. I attest that all information is true and accurate to the best of my knowledge and represents my own work.

I acknowledge the above statement as correct

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