Sierra Leone Association of Women in Journalism
MEMBERSHIP APPLICATION FORM
Vision
To build an informed gender sensitive media with empowered women journalists in leadership positions.
Mission
To advance the rights of female journalists, foster their representation within the media in Sierra Leone and promote the rights of women.
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PERSONAL INFORMATION
YOUR NAME
First Name
Last Name
MAIDEN NAME (If Married)
Street Address
Street Address Line 2
State / Province
Postal / Zip Code
DATE OF BIRTH
-
Month
-
Day
Year
PLACE OF BIRTH
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CONTACT INFORMATION:
ADDRESS
Home Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone
Email
example@example.com
INSTITUTION:
INSTITUTION NAME
INSTITUTION ADDRESS
POSITION / LEVEL
QUALIFICATION
WASSCE / EQUIVALENT
CERTIFICATE / DIPLOMA
BACHELORS
MASTERS
PHD
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REFERENCE:
Reference Information
First Name
Last Name
Mobile No.
Reference Institution
Name
Address
Position
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