Enrollment is open to students in grades 9-12. Interested students are encouraged to apply by completing the application form below. Drop off the application along with other requested materials to Dr. Adrienne Von Lates, Curator of Education at the Museum of Contemporary Art located at 770 N.E. 125th Street. Call 305-893-6211 for further information. Space is limited so complete your application today! APPLICATION DEADLINE IS Friday, May 4, 2007.

MOCA SUMMER JOURNALISM INSTITUTE APPLICATION

Name: __________________________________ Gender: Male Female

Address: Street_____________________________City___________________________Zip_____________

Email: ___________________ Phone: ________________________________________

Minority group (circle one or more): Black Hispanic Asian American Indian Other: ______________

School: ________________________________________ Grade: _______ Grade point average:_____________

School address (include city & ZIP code): _____________________________________________________________________

School Telephone (include journalism extension):____________________________________

School publication or activities: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If you have any experience in desktop publishing, list the name of the program(s): ____________________________________________________________________________________________________________________________________________

Other extracurricular activities or part-time jobs: ________________________________________________________________________________________________________________________________________________________________

Please attach your two best clippings of stories, layouts and/or photographs from your school newspaper or yearbook, or your best essay from a language arts class.

ON A SEPARATE SHEET OF PAPER WRITE A 200-WORD ESSAY TO EXPRESS YOUR INTEREST IN JOURNALISM AND ATTACH IT TO YOUR APPLICATION.