Applicant's Contact Information
Prefix
First Name*
MI
Last Name*
Suffix
Street Address*
Street Address Continued
City*
State* ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY
Zip Code*
Email*
Telephone Number*
Applicant's Additional Information
Date of Birth*
Where would you like to work? (check all that apply): District OfficeWashington DC Office
What semester are you applying for? (check all that apply): FallSpringSummerWinter
Permanent Address (if different)
Permanent Address
Emergency Contact Information
Emergency Contact Name*
Emergency Contact Telephone Number*
Skills applicable to internship
List specific issues and areas of interest to you:
Have you served a prior internship in Washington D.C. or in a district office? If yes, with whom?
Academic Information
Schools attended, beginning with your current school:*
If you are currently enrolled in college/university, please answer the following:
Is academic credit available for internships? YesNo
Years in School
Graduation Date
GPA
Major
Activities/Honors
Career Objectives
Advisor's Name*
Names and Addresses of Three References
Please use this box to write a brief paragraph about yourself, including the reasons why you would like to intern in a congressional office.
Attach Resume
