In preparation to complete this application please make sure you have a cover letter and resume ready (.txt, .doc, .docx, .pdf, .rtf). You will need names and addresses of 3 references. General Information * marks required fields of data. Applicant's Contact Information Prefix: - None -Ms.Miss.Mrs.Mr.Mr. and Mrs.Rev.Dr.The HonorableRabbi First Name: * MI: Last Name: * Suffix: - None -2nd3rd4thIIIIIIVJr.Sr.M.D.PH.D.and Family Street Address: * Street Address Continued: City: * State: * Zip Code: * Email: * Applicant's Telephone Phone Number: * Phone Type: Standard voice telephoneVideophone [VP]Text-telephone device [TTD] 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. Applicant's Additional Information Date of Birth: * Year Year19191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Permanent Address (if different) Street Address: Street Address Continued: City: State: ZIP Code: Emergency Contact Information: Emergency Contact Name: * Phone Number: * Type: Standard voice telephoneVideophone [VP]Text-telephone device [TTD] 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 standard audible telephone. Additional Relevant Information Desired Internship Date: * Desired Internship Hours: 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? * Academic Information Schools attended, beginning with your current school: * If you are currently enrolled in College/University, please answer the following: Is academic credit available for internships? Yes No Year in School: Graduation Date: Year Year20192020202120222023 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 GPA: Major: Activities/Honors: Career Objectives: Advisor's Name: * Names and Addresses of Three References: * Applicant's Cover Letter and Resume: Cover Letter: Files must be less than 2 MB.Allowed file types: txt rtf pdf doc docx. Resume: Files must be less than 2 MB.Allowed file types: txt rtf pdf doc docx. Your file size can not exceed 1MB. 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. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.