First Name

Last Name

Email Address

Address

City

State
Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Fed. States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Americans Abroad

Zip Code

Phone Number

Which department(s) are you applying for?
Field/Political
Research
Technology/Web Management
Training
Communications

Which semester?
Fall (Sept.-Nov.)
Winter (Dec.-Feb.)
Spring (Mar.-May)
Summer (June-Aug.)

Education (institutions, major, minor, and graduating year):

Academic Experience (public policy, relevant coursework, foreign language, etc.):

Political Organizing skills (canvassed, phone banked, lit drop, etc.):

Computer Skills:

Tell us a little more about yourself (extracurricular activities, hobbies, interests, etc.):

Do you need housing for your Internship?
Yes
No
We place our interns with local DFA members who have guest rooms

Please list any medical conditions or allergies that we should know about (include pet allergies if requesting housing):

Will you have a car during your internship?
Yes
No

Would you be full-time or part-time?
Full-time
Part-time

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