Response

Applicant's Contact Information:

Prefix

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip

Phone

Date of Birth:

Desired Location(s): District OfficeWashington DC Office

Desired Session(s): FallSpringSummer

Permanent Address (if different):

Emergency Contact Information:

Emergency Contact Name:

Emergency Phone Number/Type:

Additional Relevant Information:

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?

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

Year in School:

Graduation Date:

GPA:

Major:

Advisor's Name:

Activities/Honors:

Career Objectives:

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:

COVER LETTER:

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RESUME:

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