Response

                     Congressman Vern Buchanan
                                       FL-16
                           Internship Application

Personal Data:

First Name

Last Name

Permanent Address

City

State

Zip

Confirm Email

Cell Phone

Date of Birth:

Are you a United States Citizen?

Emergency Contact Information:

Emergency Contact -1

Relationship

Address-1:

Phone:

Cell Phone:

Emergency Contact-2

Relationship-2

Address-2:

Phone:

Cell Phone:

Education Information:

Current College or University:
(include city, state & zip)

Expected Graduation Date:

Major Field of Study:

Minor Field of Study (if applicable):

School Credit:

Are you receiving academic credit for this internship?

If yes, for what program?

Availability:

Dates of Availability:

What would you contribute to Congressman Vern Buchanan's Internship Program?

Work Schedule Availability:

Spring

Summer

Fall

Narrative Responses:

Which office(s) work you like to work in?

Bradenton Office

Brandon Office

Washington D.C. Office

What do you consider your most significant accomplishment?

Why do you feel you would be a good representative of Congressman Buchanan's office?

Attach resume here: (accepted file types are--.doc, .docx, .pdf & .txt)

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