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First Name
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Last Name
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Address Line 1
Address Line 2
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City
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State
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D.C.
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Zip
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Email
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Phone
Permanent Address (if different)
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Emergency Contact
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Emergency Contact Phone Number
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Is academic credit available for internships?
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No
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Schools attended, beginning with your current school:
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Year in School
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Graduation Date
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GPA
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Major
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Advisor
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Activities/Honors
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List specific issues or areas of interest to you:
Have you served a prior internship in Washington D.C. or in a district office? If yes, with whom?
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Date of Birth
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Desired Location(s):
District Office
Washington DC Office
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Desired Session(s):
Spring
Summer
Fall
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Career Objectives
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Names and Addresses of Three References:
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Please use this box to write a brief paragraph about yourself, including the reasons why you would like to intern in a congressional office:
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