Prefix
Required
First Name
MI
Required
Last Name
Required
Address Line 1
Address Line 2
Required
City
Required
State
Alabama
Alaska
America Samoa
Arizona
Arkansas
California
Colorado
Connecticut
D.C.
D.C.
Delaware
Federated States of Micronesia
Florida
Foreign Correspondence
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Trust Territory
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Required
Zip
Required
Email
Required
Cell Phone
Required
DOB:
Permanent Address (if different)
Required
Emergency Contact
Required
Emergency Contact Phone
Academic Information
Required
Is academic credit available for internships?
Yes
No
Required
Schools attended, beginning with your current school:
Required
Year in School:
Required
Graduation Date:
Required
GPA:
Required
Major:
Required
Advisor's Name:
Required
Activities/Honors:
Required
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?
Required
Desired Location(s):
District Office
Washington DC Office
Required
Desired Session(s):
Spring
Summer
Fall
Required
Career Objectives:
Required
Names and Addresses of Three References:
Required
Please use this box to write a brief paragraph about yourself, including the reasons why you would like to intern in a congressional office:
Required
Cover Letter
Upload File
No file chosen
Required
Resume
Upload File
No file chosen