Please complete and submit the form below to apply for an internship in one of our offices. Ensure that you have your cover letter and resume ready to upload at the end of this form. Submitting these documents is required. Current Page 1 Complete Indicates required field Your Information Prefix: - Select -Ms.Miss.Mrs.Mr.Mx.Rev.Dr.The HonorableRabbi First Name: MI: Last Name: Suffix: - None -2nd3rd4thIIIIIIVJr.Sr.M.D.PH.D.and Family CAPTCHA: enabled to secure this form. If you are having difficulty using Captcha's visual option, please visit the Accessibility page for more assistance. Your Contact Information Address Address Address 2 City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code Email: Telephone Phone Number: Phone Type: - None -Standard voice telephoneVideophone [VP]Text-telephone device [TTD] phone text What are these options? Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option 'Voice' is a standard audible telephone. Permanent Address (if different) Permanent Address Address Address 2 City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Emergency Contact Information: Emergency Contact Name: Emergency Phone Number: Phone Type: - None -Standard voice telephoneVideophone [VP]Text-telephone device [TTD] Academic Information Is academic credit available for internships? Yes No Relevant if you are currently enrolled in College/University. Schools attended, beginning with your current school: Year in School: Graduation Date: Month MMJanFebMarAprMayJuneJulyAugSepOctNovDec Day DD01020304050607080910111213141516171819202122232425262728293031 Year GPA: Major: Advisor's Name: Activities/Honors: Skills applicable to internship 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? Applicant's Additional Information Date of Birth: Month MMJanFebMarAprMayJuneJulyAugSepOctNovDec Day DD01020304050607080910111213141516171819202122232425262728293031 Year Desired Location(s): - Select -District OfficeWashington DC OfficeDistrict Office and Washington DC Offices Desired Session(s): - Select -FallSpringSummerFall, Spring, Summer 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: One file only.2 MB limit.Allowed types: txt rtf pdf doc docx. Resume: One file only.2 MB limit.Allowed types: txt rtf pdf doc docx. file text Your file size can not exceed 2MB. Documents must be the following file types: .doc, .docx, .pdf, .rtf, .txt Mac users: Your document must have a file extension. Resave it using your word processor with the appropriate extension from the above list.