THE BRAUNER FOUNDATION
250 South End Avenue, Suite 15B
New York, NY 10280
Phone: (212) 945-2749
Fax: (212) 945-3412


Zaline Scott-McShan Memorial Scholarship

****
It is the sole responsibility of applicants to ensure
compliance with all requirements.  Faxed applications and
supporting documents will not be accepted under any
circumstances.  Please enclose a self-addressed stamped envelope
if you wish to be notified of application receipt.
****



     PART I:  Personal Data

FULL NAME ______________________________________________________

AGE _______  D.O.B. ______________________  SEX ________________

SOCIAL SECURITY NO. ____________________________________________




Current Contact Information:

STREET ADDRESS _________________________________________________

CITY/TOWN _______________  STATE _____  ZIP/POSTAL CODE ________

HOME PHONE ___________________________



Permanent Contact Information:

STREET ADDRESS _________________________________________________

CITY/TOWN _______________  STATE _____  ZIP/POSTAL CODE ________

HOME PHONE ___________________________




What do you consider to be the most significant developments in
broadcasting and marketing over the past five years and where do
you see yourself within this industry five years from today?

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________




NAME and RELATIONSHIP of person to be notified in an emergency:

________________________________________________________________


WORK PHONE: ___________________  HOME PHONE: ___________________





     PART II: Educational Background


Beginning with the most recent, list the educational
establishments you have attended:

NAME & LOCATION         MAJOR/MINOR     DEGREE/YEAR EARNED   GPA

_______________________ _______________ ____________________ ___

_______________________ _______________ ____________________ ___

_______________________ _______________ ____________________ ___

_______________________ _______________ ____________________ ___




     PART III: Language Proficiency

Please mark yourself as being FLUENT, GOOD, or FAIR in any of
the following that apply:

ENGLISH: Reading ________   Writing ________   Speaking ________

SPANISH: Reading ________   Writing ________   Speaking ________

OTHER:   Reading ________   Writing ________   Speaking ________
_________




     PART IV: Names, Addresses, and Phone Numbers of
              hometown newspapers

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________




     PART V: Essay Questions (attach extra sheets as necessary)

1) Describe yourself, your background and any special
   circumstances that have shaped your identity.
2) Define leadership.  How do you fit that definition?  Please
   give concrete examples of situations in which you displayed
   leadership abilities.
3) When you are part of a work team, discussion group or
   collective effort, what roles are you likely to play?
   Please offer examples.





Please sign the following:
The information given above is complete and accurate to the best
of my knowledge.  I hereby give permission to share this
information for the purpose of recruitment and public relations.

SIGNATURE __________________________________  DATE _____________




Submit this application with the following materials:
- Current Official Transcripts.  No copies, no exceptions.
- Three letters of recommendation.  One each from:
  Faculty Member, Community Leader, Employer.
- A current résumé (1 page).
- One writing sample on any topic (not to exceed ten pages).