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Prefix
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First Name
MI
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Last Name
Suffix
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Address Line 1
Address Line 2
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City
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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
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Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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New Jersey
New Mexico
New York
North Carolina
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Northern Mariana Islands
Ohio
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Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Trust Territory
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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Zip
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Phone
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Email
Permanent Address (if different)
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Emergency Contact Name
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Emergency Phone Number
Is academic credit available for internships?
Yes
No
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Schools attended, beginning with your current school
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Year in School
Required
Graduation Date
Required
GPA
Required
Major
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Advisor Name
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Activities/Honors
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List specific issues or areas of interests
Required
Have you served a prior internship in Washington D.C. or in a district office? If yes, with whom?
Date of Birth:
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Desired Location
District Office
Washington DC Office
District Office and Washington DC Offices
Required
Desired Session(s)
Spring
Summer
Fall
Fall, Spring, Summer
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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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Cover Letter:
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Resume:
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