PERSONAL INFORMATION

Name

Current Address

Current Telephone

Best time of day to reach you

Permanent Address

Home Telephone

Date of Birth

U.S. Citizen?

Yes    No

Parent/Guardian

Email Address

Specific dates available for internship (very important):

EDUCATION

School You Attend

Year in School

Major(s)

Cumulative GPA

Honors, Scholarships,
Fellowships

Extra-Curricular Activities

OCCUPATIONAL EXPERIENCE

Please list all work experience beginning with the most recent

1.   

2.

3.

4.

References

1.

2.

3.

Briefly explain why you would like to be an intern with the Public Forum Institute

What do you hope to achieve during your internship in Washington?

Are there any types of work in which you have a special interest?  If so, please check:

Are there any particular policy issues that interest you?

How did you learn of the Public Forum Institute's intern program?

When you have completed the internship application:
click the submit button once.