Application For Nomination To US Service Academies

Congressional Intern Application Congressman Mark Walker North Carolina Sixth District

Please print out application, write-out answers, scan, and send to [email protected].

I. Personal Information

Name: ______(Last) (First) (Middle)

Preferred Name (if different from above): ______

Preferred Office: DC ______District ______

Preferred Internship (indicate year): summer ______fall semester ______spring semester ______

Date of birth: ______Social Security Number: ______

Permanent Address:

______(Street) (Apt.)

______(City, state, zip+4) (County)

Temporary Address (School):

Contact number: ______E-mail Address: ______

Are you a US Citizen? Y / N

Are you a legal resident of the Sixth Congressional District of North Carolina? Y / N

Congressman Mark Walker --Intern Application Page 1 Father’s Name: ______

Father’s Address:

Contact Number: ______

Mother’s Name: ______

Mother’s Address (if different):

Contact Number: ______

II. High School/College Information:

School: ______

Address: ______

Phone Number: ______

Current Year: ______Year you will graduate: ______

List any majors/minors/degree programs: ______

Current Overall GPA: ______

III. Extracurricular Activities:

List any academic honor societies to which you belong:

______

List any significant offices you have held since entering ninth grade:

______

Congressman Mark Walker --Intern Application Page 2 Extracurricular activities have you participated since entering ninth grade? (please include any leadership roles, i.e. ‘Captain’):

______

Describe your computer skills, including programs with which you are familiar and the level of proficiency you possess:

______

Describe any job, internship, or volunteer experience you have had:

______

List your primary interests and hobbies:

______

What interests you in an internship with Rep. Mark Walker?

______

Congressman Mark Walker --Intern Application Page 3 IV. Essay:

Write a brief character sketch of yourself. Include your basic attributes and those qualities that you believe are your strengths.

______

V. Return Forms:

Applicants must send the following materials to [email protected] and have the subject line identity what internship is being applied for (i.e. ‘District Internship’, ‘D.C. Internship’):

 Completed application  Resume  Writing sample

Applicants may either send recommenders the link the internship webpage or download the recommendation forms and send to them. Recommenders must send the following forms to [email protected] and have the subject line identity the applicant (i.e. ‘Susie Quinn’):

 Have a teacher, coach or employer who is not related to you complete the Teacher/Coach/Employer recommendation form.  Have one other person that knows you well, but is not related to you complete the personal recommendation form.

VI. Signature:

The following information on this form and any attachments or enclosures to it are true, complete, and correct to the best of my knowledge.

______(Signature) (Date)

Congressman Mark Walker --Intern Application Page 4 Questions? Please contact Olga Perkins at Congressman Walker’s Greensboro District Office at (336) 333-5005 or by e-mail at [email protected] or Louis Altobelli of Congressman Walker’s D.C. Office at (202) 225-3065 or by e-mail at [email protected]

Congressman Mark Walker --Intern Application Page 5