Application must be submitted no later than December 22, 2017

**FILL OUT FORM AS COMPLETELY AS POSSIBLE**

Newspaper:
City:
Telephone:
Fax:
Publisher/GM Name Email
Editor Email
Ad Manager Email
Intern Preference
(Check all that would be applicable to this application)

Editorial

Advertising

Photography

Online

If applying for a Photography intern, will your newspaper furnish the equipment? Yes No
Duties of the intern:
Amount and kind of supervision to be provided :

Intern's immediate supervisor at the newspaper

Name: E-Mail:
Total number of newspaper staff members
Editorial
Advertising
Photo
Type of computer intern will be using at the newspaper:
Software the intern will be using :
Do you require that the student already be trained or familiar with this equipment?: Yes No

In applying for a Kentucky Journalism Foundation intern, your newspaper agrees to:

• arrange intern's schedule to be equivalent to full-time status

• interview at least two or more intern applicants

• select an intern no later than March 18, 2018. If you have not completed the interviews by this date, you will forfeit the internship for 2018

• apply all of the money paid by the Kentucky Journalism Foundation to the intern's salary

• pay all income taxes, Social Security and workers' compensation costs

• should the intern's employment end any time prior to the scheduled 10-week internship period, notify KPA immediately and return any unused amount to KPA

Publisher's "Signature": You must agree to the terms to apply
My newspaper and I agree to the terms and conditions of the Kentucky Journalism Foundation internship program as stated above.

Complete this application no later than December 22, 2017