Internship Application Form

The Kenneth L. Maddy Institute Legislative Intern Scholar Program
2016-2017 Application
.

All decisions of The Maddy Institute Scholarship Committee are final and confidential. Applications become the property of The Maddy Institute; and, if selected, maybe distributed to participating government offices. Applications that are incomplete or submitted after the deadline will not be considered. .

I. PERSONAL INFORMATION.

Last Name*

First Name*

Middle Initial

College*

Major*

Graduation Date

Student ID*

Address*

Home/Cell Ph.*

Work Ph.

Personal Email*

CSU/UC Email*

II. REFERENCES.

Please list at least 3 individuals who will serve as a reference. Include at least 1 faculty member and 1 current or former employer. Do not reference family members or friends. All fields must be filled. .

1.) Last Name*

First Name*

Address*

Phone Number.*

Email

Relation (faculty, employer, etc.)

2.) Last Name*

First Name*

Address*

Phone Number.*

Email

Relation (faculty, employer, etc.)

3.) Last Name*

First Name*

Address*

Phone Number.*

Email

Relation (faculty, employer, etc.)

III. Placement.

Internship Location. Please mark all areas in which you are willing/applying to serve an internship..

Fall-LocalSpring-LocalSummer-LocalSummer-Sacramento, CASummer-Washington D.C..

If applying for summer, list the city you will be living in

Areas of Interest. Please mark any areas that interest you..

AgricultureAir QualityArmed ForcesBankingBudgetCommerceConservation.

DrugsEnergyEnvironmentFinanceForeign AffairsGlobal WarmingGlobalization.

Government ReformHealthHigher EducationHomeland SecurityHousingImmigration.

Indian AffairsJudiciaryK-12 EducationLaborLaw EnforcementMedicare/Medicaid.

Natural ResourcesPensionPublic AdvocacyRenewable EnergyScience & Technology.

Small BusinessSocial SecurityTelecommunicationsTerrorismTradeTransportation.

VeteransWater.

*By submitting this form, I certify that all of the statements contained in my application are true, complete, and correct to the best of my knowledge. I am prepared, in good faith, to fulfill all components of The Maddy Institute Intern Scholar Program..

To complete the application you still need to submit to via email the following documents:

❒ Resume: Must be current and completed.
❒ Personal Statement: No longer than ONE page. Write a short biographical sketch. How would the
legislative office benefit from having you in the office? What interest, experience, or background
do you have in public policy or government affairs (school, work, volunteerism, etc.)?
❒ College Transcripts: Copies are acceptable. Your name must appear on the document. Official
transcripts indicating expected graduation date and degree will be required of all applicants selected for the program.