Local government fellowship application form and story pitch template

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Bio data

  1. First name:

  1. Last name:

  1. Gender:

  1. What is your age?

  1. Primary email address:

  1. Primary phone number:

  1. Alternative phone number:

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

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

  1. How long have you been in your current position?

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

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

  1. Phone number and email of your editor, manager or editorial supervisor:

Professional background

Please answer in full and answer honestly. ACME will contact your media house to verify the claims made in your application.
  1. What is your journalistic history? (In no more than 250 words, please provide your professional (journalistic) biography, focusing on the highlights of your career to-date)


  1. Catch phrase/Key words or preliminary idea for a working title [One Sentence]

  1. WHAT is the story about? What’s the key issue? [A few sentences]

  1. What has CHANGED? What’s NEW and/or SURPRISING about this story? Why is it worth covering NOW as opposed to last month, last year, or two years from now, and what, if anything, would your reader/viewer/audience be surprised to learn in this story? [Be sure to back up claims about change with evidence, however preliminary it may be]

  1. WHO CARES? What’s the SIGNIFICANCE of the story? Why does it MATTER?

  1. What does your PRELIMINARY RESEARCH about the issue show? [You could include some brief background here, where appropriate. You could also mention if you have engaged with the issue/subject of investigation previously]

  1. What QUESTIONS will you attempt to answer in order deliver depth? [e.g. What are the causes of this? How does this work? What’s the impact of this? Who benefits? Who loses? What are the (hidden) interests behind this? Where is this coming from? How has this been handled elsewhere?]

  1. What’s the SCOPE of the story? [e.g. How widespread is the development? Is it local, regional, national? How many people are affected?]

  1. What TYPE of story will you be doing? [a special or investigative report, a series, a TV or radio documentary, a radio package, a multimedia report; a combination of reports including Q & A interviews, talk shows, etc?

  1. What REPORTING METHODS do you plan to employ to deliver the story? [e.g. Review or analysis of reports, interviews, data mining, etc]

  1. What SOURCES/RESOURCES do you plan to use to prepare this story? [List a few DATA sources you plan to draw on, showing how and/or what you will use them (for)].

  1. How LONG will it take you to deliver the story? [Provide a reasonable timeline or date by which you will have completed the story]

  1. What is your estimated BUDGET for delivering the story? [Provide a breakdown e.g. transport, accommodation, meals, airtime, etc; For Grant applications, explain why you need external funding to deliver the story]

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