Internship Form

Note: Fields marked with an * are required.

Personal Information

Prefix

First Name *

Middle Initial

Last Name *

Suffix

Position Title

Street Address *

Address 2

City *

State * Florida

Zip Code *

E-mail Address *

Telephone Number

Education Information

Name of College/University *

College/University Street Address *

Street Address 2

City *

State * Florida

Zip Code *

GPA *

Major

Minor

List any past work experience or extracurricular activities

Internship Interests

Areas of Interest

Press

Legislative

Do you have transportation?

Yes

No

Would you have housing during your internship?

Yes

No

Please indicate the days and hours which you would be able to intern

Dates available to intern

Which office would you like to intern in? * Washington Tallahassee Panama City

Would you receive credit for this internship?

Yes

No

Graduation Date

Are you familiar with Microsoft Word?

Yes

No

Additional Information

Please email a cover letter, resume, and one-page writing sample to Kathryn.Whitehurst@mail.house.gov.