Application Form for the participants
Of the "Golden Fern" International Journalism Contest

* The trustworthiness of information is provided by the availability of the original print media or corresponding confirmation document certified by the chief editor
1. Participant’s information

Author’s initials*

Contacts (e-mail, phone number)*

2. Information about the journalist’s work submitted to the Contest

Name of material*

Format of material (interview, reporting comments, analytical article, etc.)*

Brief content of material (not more than 3 sentences)*

Category that corresponds to the material’s content *

Material size (in thousands of signs, seconds/minutes)*

Release date of printing/ broadcast**

3. Information about the media represented by the Contest’s participant

Name of mass media*

Kind of mass media:*:

Thematic specialty of the edition*

Name of edition’s column/section where the material was placed*

 

Edition’s circulation*

Region(s) of distribution*

Edition’s contact information*

  
  • Editorial office’s actual address, telephone and e-mail*
  • Initials, telephone number and e-mail of the chief editor or the column’s/section’s editor**
** Filling in this point is optional.