Post Journalist Membership Applications January 26, 2015 Which membership type are you applying for?: * Journalist Membership Supporting Community Membership Community Membership Student Membership Personal Information First Name: * Last Name: * Street: * City: * State/Province: * Country (if not U.S.): Zip/Postal Code: * Phone: Email Address: * Your preferred email address. Birth Year: * Gender: * - Select -FemaleMale Professional Information Employer: * Employer's Industry Sector: * - Select -Media: Daily Print Publication (including online)Media: Weekly Print Publication (including online)Media: Online-only PublicationMedia: JournalMedia: MagazineMedia: RadioMedia: TelevisionMedia: Freelance Writer (majority of work is journalism)Media: Freelance Writer (majority of work is other kinds of writing)Media: BlogMedia: OtherPublishing: Books, Educational Materials, CurriculumPublishing: JournalEducation: College/UniversityEducation: College/University-associated nonprofitEducation: For-profit Educational Services ProviderEducation: Local/State/Fed Department of EducationEducation: Schools/School District/School Board/School Administrator or EmployeeNonprofit: Association/Coalition/UnionNonprofit: Journalist Association/Journalist ServicesNonprofit: Grantmaking FoundationNonprofit: Operating FoundationNonprofit: Policy Institute or Think TankNonprofit: Primarily Providing Direct Educational ServicesNonprofit: Primarily Serving Educational ProvidersPR: Communications, PR Consulting, Marketing, Media Relations, Strategy, PromotionsOther Employer's Website: * Job Title: Employer-Provided Email Address: Providing an employer-provided email address will speed up the application review period. Personal/Professional website, column, blog, etc.: Personal/Professional Twitter handle: @ I work for: * - Select -a not-for-profit.a for-profit.both a not-for-profit and a for-profit organization.unemployed/retired.self-employed. Additional Questions for Journalist Applicants How long have you been a journalist?: * - Select -Less than 2 years2-56-1011-15Over 15 years Which category best describes your position?: * - Select -BloggerBroadcast ProducerEditorFreelance JournalistOn-air BroadcasterOpinion WriterReporterOther Do you ever report, write, produce, edit, or otherwise prepare editorial content that represents your own opinions or expresses those of an employer, client or organization?: * Yes No If yes, please provide links.: How much of your professional work is focused on journalism, rather than work such as policy analysis, research, consulting, teaching, speech-writing or writing for non-journalism clients or publications?: * 0-25% 26-50% 51-75% 76-99% All my time What percentage of your time is devoted to education coverage?: * 0-25% 26-50% 51-75% 76-99% All my time Check the areas of education you cover:: * Early Education P-12 Higher Education Please list any books on education or journalism that you wrote, co-wrote, edited, or co-edited. : List all the publications where bylined pieces by you have appeared in the past 12 months, with a link to at least one piece in each publication.: List all the publications where pieces that you produced but that appeared without your byline were published in the past 12 months. Please supply links to any such pieces.: Are you involved in, work for, or belong to any groups, networks, or organizations engaged in efforts to influence education policy or practice?: * Yes No If yes, please identify them and describe your role.: Do you currently teach journalism?: * Yes No If so, where and in what capacity?: Do other journalists in your organization also cover education?: Yes No
