Youth in the 21st Century: Debating and Producing Media

Sponsored by the Open Society Institute

Chaing Mai, Thailand, July 5-18, 2010

Family Name ________________________ Given Name _______________________________

Current Address __________________________________________________________________

Country of Citizenship ____________________ Country of Residence _______________________

Phone number __________________________ Email address _____________________________

Date of Birth: Date ____________ Month __________________________ Year _______________

Current school or employer _________________________________________________________

Highest Degree Attained _____________Date ______________School _______________________

Please attach a Curriculum Vitae (CV).

Note to Applicant: The following questions are designed to assess the reasons why you are interested in
the Youth in the 21st Century workshop as well as how we can cater the curriculum and teaching to the
needs of the participants. You should not feel that there are 'right' or 'wrong' answers to these
questions. The best way to answer these questions is honestly and insightfully. If you are accepted to
the workshop, you may be asked to complete a more detailed questionnaire about your engagements
with media and debate.

1. From what media sources do you get most of your information? Please rank your top 3.
___ Print newspapers or magazines
___ Online news websites (including mobile device applications)
___ Blogs
___ Television
___ Text messaging service
___ Radio
___ Bulletin boards/posters/flyers
___ Public forums/speeches/meetings
___ Internet video
___ Other (please specify) ___________________________

2. Do you produce any media? If so, what? If not, why are you interested in learning?

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3. What form(s) of media are you interested in learning how better to use?

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4. Have you ever debated before? If so, in what context and how often? If not, why are you
interested in learning how to debate?
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5. How do you see the relationship between the media and citizenry in your society? What, if
anything, would you like to change about this relationship?
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6. Why do you want to attend the Youth in the 21st Century workshop?

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