MDIF Myanmar Media Program 2 Application
Online Application Form for Media Organisations Interested in Participating in the MMP2.
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1. Media Name *
2. Type of Organisation (Choose One Only) *
Required
3. How many full-time employee do you have? *
4. How many part-time employees do you have? *
5. Please list the names of the directors of your organisation. *
6. If your organisation is a private company, please list the principal shareholders of your company.
7. Name of Participating Media Executive *
7a. Media Executive Contact Details: Email *
7b. Media Executive Contact Details: Mobile Number *
8. Media Office Address: *
8a. Media Organisation's Web Address (if applicable). Answer must begin http://
8b. Media Organisation's Facebook Page Location (if applicable).  Answer must begin with http://
9.  When was your media organisation founded? Month and Year. *
10.  What are your personal goals for participating in MDIF's Myanmar Media Program (250 words or less) *
11. How would you define your media's primary audience?  (Choose one only) *
Required
12.  Please indicate all of the media types that you produce to reach your monthly audience? (Choose all that apply) *
Required
13.  Please choose the one media that is most important to reaching your monthly audience? (Choose one only) *
Required
14. During the past 12 months, what was your media's average monthly audience for your primary media type selected in Question 13 above? For online media, do not include your social media/Facebook reach (Choose one only) *
Required
15. Please indicate your media organisation's annual expense budget for the most recent year. (Choose one only) *
Required
16a. Please rank the following revenue types based on their relative importance to your organisation's income.   *
Not Important
Somewhat Important
Very Important
Extremely Important
Grants
Individual Donations
Subscriptions/Sales
Advertising
Syndication
Other
16b. If you ranked "Other" in question 16a as either "Very Important" or "Extremely Important", please describe the "other" revenue type.
17.  Please describe the major goals you would like your media organisation to achieve by December 2019. (250 words or less) *
18.  Other than financial resources and government policy, what do you see as the major challenges to achieving these goals?  (250 words or less) *
19.  Over the past 12 months, please choose one piece of reporting (in any language) from your media and describe its importance to your audience. (250 words or less) *
20.  If available, please provide an online link to the story, video or audio program described in question 19.   Answer must begin http://
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