Application for ACME's workshop on election reporting

Bio data

You are invited to fill out, in full, this application form. Please provide ALL information required.

Incomplete forms with unanswered or partially answered questions will not be considered.

Thank you.

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* 1. First name

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* 2. Last name

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* 3. Gender

Female

Male

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* 4. What is your age bracket?

Between 18 - 25

Between 26 - 35

Above 35

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* 5. Primary email address

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* 6. Primary phone number

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* 7. Alternative phone number

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* 8. Name, address and phone number of the newspaper, radio, TV station or online news platform for which primarily work.

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* 9. What is your current position at the media house named above?

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* 10. How long have you been in your current position?

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* 11. What is the name of the town or city in which you work?

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* 12. Name and position of your editor, manager or editorial supervisor

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* 13. Phone number and email of your editor, manager or editorial supervisor