Response

Internship Application

Applicant's Contact Information

Prefix

First Name

Last Name

Suffix

Address Line 1

Address Line 2

City

State

Zip

Phone

Applicant's Additional Information

Date of Birth:

Where would you like to work (Check all that apply):

District Office
Washington DC Office

Desired semester(s) for internship:

Summer
Spring
Fall

Internship Start Date:

Internship End Date:

Permanent Address (If different)

Emergency Contact Information

Emergency Contact Name:

Phone Number:

Additional Relevant Information

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?:

Schools attended, beginning with your current school:

If you are currently enrolled in College/University. Is academic credit available for internships?:

Year 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.

OFFICE LOCATIONS

WASHINGTON DC OFFICE • 1524 Longworth House Office Building • Washington, DC 20515 • Phone: (202) 255-5931

NEWTON DISTRICT OFFICE • 29 Crafts Street Suite 375 • Newton, MA 02458 • Phone : (617) 332-3333

ATTLEBORO DISTRICT OFFICE • 8 N. Main St. Suite 200 • Attleboro, MA 02703 • Phone : (508) 431-1110

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