<p> Congressional Intern Application Congressman Mark Walker North Carolina Sixth District</p><p>Please print out application, write-out answers, scan, and send to [email protected].</p><p>I. Personal Information</p><p>Name: ______(Last) (First) (Middle)</p><p>Preferred Name (if different from above): ______</p><p>Preferred Office: DC ______District ______</p><p>Preferred Internship (indicate year): summer ______fall semester ______spring semester ______</p><p>Date of birth: ______Social Security Number: ______</p><p>Permanent Address: </p><p>______(Street) (Apt.)</p><p>______(City, state, zip+4) (County)</p><p>Temporary Address (School): </p><p>______(Street) (Apt.)</p><p>______(City, state, zip+4) (County)</p><p>Contact number: ______E-mail Address: ______</p><p>Are you a US Citizen? Y / N </p><p>Are you a legal resident of the Sixth Congressional District of North Carolina? Y / N</p><p>Congressman Mark Walker --Intern Application Page 1 Father’s Name: ______</p><p>Father’s Address: </p><p>______(Street) (Apt.)</p><p>______(City, state, zip+4) (County)</p><p>Contact Number: ______</p><p>Mother’s Name: ______</p><p>Mother’s Address (if different): </p><p>______(Street) (Apt.)</p><p>______(City, state, zip+4) (County)</p><p>Contact Number: ______</p><p>II. High School/College Information:</p><p>School: ______</p><p>Address: ______</p><p>Phone Number: ______</p><p>Current Year: ______Year you will graduate: ______</p><p>List any majors/minors/degree programs: ______</p><p>Current Overall GPA: ______</p><p>III. Extracurricular Activities:</p><p>List any academic honor societies to which you belong:</p><p>______</p><p>______</p><p>______</p><p>List any significant offices you have held since entering ninth grade: </p><p>______</p><p>______</p><p>______</p><p>Congressman Mark Walker --Intern Application Page 2 Extracurricular activities have you participated since entering ninth grade? (please include any leadership roles, i.e. ‘Captain’): </p><p>______</p><p>______</p><p>______</p><p>Describe your computer skills, including programs with which you are familiar and the level of proficiency you possess: </p><p>______</p><p>______</p><p>______</p><p>Describe any job, internship, or volunteer experience you have had: </p><p>______</p><p>______</p><p>______</p><p>List your primary interests and hobbies: </p><p>______</p><p>______</p><p>______</p><p>What interests you in an internship with Rep. Mark Walker? </p><p>______</p><p>______</p><p>______</p><p>Congressman Mark Walker --Intern Application Page 3 IV. Essay:</p><p>Write a brief character sketch of yourself. Include your basic attributes and those qualities that you believe are your strengths.</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>______</p><p>V. Return Forms:</p><p>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’):</p><p> Completed application  Resume  Writing sample</p><p>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’):</p><p> 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. </p><p>VI. Signature:</p><p>The following information on this form and any attachments or enclosures to it are true, complete, and correct to the best of my knowledge. </p><p>______(Signature) (Date)</p><p>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] </p><p>Congressman Mark Walker --Intern Application Page 5</p>