District Internships

District Internship Application

Note: Fields marked with an * are required.

Contact Information

Prefix

Ms. Miss. Mrs. Mr. Mx. Rev. Dr. The Honorable Rabbi

First Name *

Middle

Last Name *

Suffix

2nd 3rd 4th II III IV Jr.

Street Address *

Street Address Continued

City *

State *

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

Email Address *

Telephone

Telephone Number *

Phone Type *

Voice VP TTD

What are these options?

This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option “Voice” is a normal audible telephone.

Applicant's Additional Information

Date of Birth *

Preferred Office Location *

DC

District

Availability Period

Permanent Address (if different)

Street Address

City

State *

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code

Emergency Contact Information

Emergency Contact Name *

Telephone Number *

Phone Type *

Voice VP TTD

Skills applicable to internship

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?

Academic Information

Schools attended, beginning with your current school *

Is academic credit available for internships?

Yes

No

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. *

Human Validation

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