Washington DC Summer Study 2017 - Application Form

Name

School Address

School Phone or Cell Phone

Home Address

Current Class Standing

	First Year
	Sophomore
	Junior
	Senior

School

	CSB
	SJU

List your major(s) and minor(s):

	Major
	Major
	Minor
	Minor

When do you anticipate graduating?

What is your current GPA?

Are you a US Citizen?

	Yes
	No

Languages / Fluency Level:

In what state are you officially a resident for voting purposes?

What is your Congressional Distict?

Who is the U.S. Representative for this District?

Do you wish to seek an internship with your own Representative or Senator, or another member of Congress?

	Yes
	No

If "yes" please indicate whom and explain why:

Do you or your family have any social or professional connection with this member of Congress?

	Yes
	No

If yes, what is that relationship?

What public policy areas or issues interest you the most?

What other internships might be of interest to you (e.g. federal agencies, professional associations, non-governmental organizations)?

These courses might help you in your internship. Which have you already taken?

Other relevant courses:

What other relevant experiences have you had?

Have you reviewed the DC Program information in the Farry lounge binders?

	Yes
	No

Briefly describe why you would like to be part of the Washington Summer Study Program:

Do you have any behavior/conduct violations on your record? If YES, please explain the incident. Please note that falsifying this section and any other section of your application may exclude you from the selection process. If you have questions concerning your violations, please contact the Dean of Students Office (CSB, x5061; SJU, x3512).

REFERENCES: List three individuals willing to write a letter of recommendation for you. At least two must be college professors, and the third should be someone who knows you well personally.

	Name #1
	Address & Phone #:
	Name #2:
	Address & Phone #:
	Name #3:
	Address & Phone #:

Leave this blank, it's here to thwart SPAM bots.

	May 2017
	December 2017
	May 2018
	December 2018
	May 2019

	POLS 111 - Intro to US Politics
	POLS 121 - Intro to International Relations
	POLS 222 - Analysis of US Policy & Elections
	POLS 224 - Courts, Law, and Policy
	POLS 332 - Congress
	POLS 334, U.S. Bureaucracy and Regulatory Law
	POLS 330, Environmental Politics and Policy
	POLS 331, U.S. Political Parties and Elections
	Another Upper Division Political Science Course
	ECON 111 - Intro to Economics
	One or more 300-Level Economics Courses

DC Application

Washington DC Summer Study 2017 - Application Form

College of Saint Benedict

Saint John’s University