Congressman Chuck Fleischmann
3rd District, Tennessee
Washington DC INTERNSHIP APPLICATION
Please type or print clearly. When you have completed this application, please enclose your resume and email it to . If you have questions or need assistance, please call 202-225-3271
NAME: ______S.S. #______
Are you over 18 years of age: ______
Present address: ______
City: ______State: ______Zip Code: ______
Cell Phone: ______E-Mail: ______
Parents’ names: ______
Permanent (home) address:______
City: ______State:______Zip Code: ______
Phone: ______
High School: ______G.P.A.______
College: ______G.P.A.______
Major/Minor: ______ Year in School: ______
Will you receive credit for this internship? ______
Name of Intern Coordinator______Phone: ______
DATES AVAILABLE TO START & END INTERNSHIP: ______
*****NOTE***** We receive applications from many talented young people and due to the amount of training involved, an applicant who makes himself, or herself, available to work for a longer tenure will be given greater consideration during the application process.
DAYS & TIMES OF THE WEEK AVAILABLE FOR INTERNSHIP:
Time Available
PLEASE LIST ANY SPECIFIC DATES YOU WILL BE UNAVAILABLE TO WORK DURING THE INTERNSHIP PERIOD:
· ______
· ______
· ______
______
Please list below your computer knowledge/skills:
List three of your favorite books:
1.)
2.)
3.)
Below are a number of organizations, people, and publications involved in public policy. For those you recognize, place: A plus (+) in front of those you agree with on most issues, a minus (-) in from of those you disagree with on most issues, a zero (0) in front of those you know, but have no strong feelings about, and leave BLANK those you do not know.
___ MoveOn.org ___ American Civil Liberties Union ___ National Organization of Women
___ Common Cause ___ National Education Assoc ___ National Right to Work Committee
___ World Bank ___ CATO Institution ___ Rev. Billy Graham
___ Brookings Institution ___ Pat Buchanan ___ National Rifle Association
___ English First ___ Empower America ___ Sierra Club
___ Heritage Foundation ___ AFL-CIO ___ Jon Stewart
___ Americans for Democratic Action ___ Nancy Pelosi ___ George W. Bush
___ U.S. Chamber of Commerce ___ Rush Limbaugh ___ Ronald Reagan
___ Greenpeace ___ NATO ___ The United Nations
___ Milton Friedman ___ OSHA ___ Amnesty International
___ National Review Magazine ___ Bill Clinton ___ Fox News
___ MSNBC ___ Family Research Council ___ George Soros
List three (3) persons historical or current that you most admire (exclude family members):
1.)
2.)
3.)
SHORT ANSWER QUESTIONS:
Please answer the following questions in the space provided below:
1.) List the names of any campus organizations to which you belong, the positions you have held in each, if any:
2.) List the major non-campus, civic, social, or political activities in which you have participated in the last five years. What do you consider to be your most significant contribution to these organizations?
3.) Describe what you enjoy doing in your leisure time?
4.) Describe any jobs you have held over the last five years and how these experiences would prepare you to work in Congressman Fleischmann’s office:
5.) Explain why you want to be an intern for Congressman Fleischmann. What do you consider to be your major strengths and qualifications for the program? What benefits do you feel are likely to result from your participation?
Please list three (3) references and include name, address and phone number and your affiliation with that person:
1.)
2.)
3.)
(Please enclose a copy of your resume)