The following is our printable application form. Print it, fill it out completely and mail it to the address listed in bold towards the bottom.

WASHINGTON INTERNSHIP PROGRAM APPLICATION FORM AND PROGRAM COSTS

 

Applicants should complete this form and include a check or money order for $1,000 (made out to the Washington Internship Program), which will be returned should the applicant not be accepted into the program. Alternatively, payment can be made by credit card ($1,020 on Visa or MasterCard) through Pay-Pal on the costs page of website: (www.washingtoninternship.com/costs.html).

Check the following box if credit-card payment has been made through Pay-Pal:

Including a resume is recommended but not required.
Prospective interns are encouraged to apply early.

Rolling Admission: Applications will be processed in the order received.

Name_______________________________________ Male ___   Female ___

Academic Level (last year of college or graduate school completed)___________________________

College __________________________________________________________________

Campus Address___________________________________________________________

Campus Phone ______________________________

Home Address (if different) __________________________________________________

Home Phone ________________________________

eMail Address ___________________________________________________

International Students and non-U.S. citizens: Select status or expected status:
F-1 Student J-1 Permanent Resident Other________________________________________

Educational Institutions Attended

_____________________________________________________________________________________
College City, State Dates of Attendance Degree received/expected

______________________________________________________________________________________
College City, State Dates of Attendance Degree received/expected

_______________________________________________________________________________________
Graduate/Professional School City, State Dates of Attendance Degree received/expected

________________________________________________________________________________________
Graduate/Professional School City, State Dates of Attendance Degree received/expected

Experience, paid and volunteer Include job title, name and location of employer, dates of employment, and brief description of duties

Special Skills (computer, foreign languages, etc.)

Awards

Travel

Extracurricular Activities

**Areas of Interest________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

**Possible Placements Desired (list organizations or agencies by name or type.):
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

References (name, affiliation, address, and phone number):
1.
2.

Housing: Do you expect to need assistance finding housing? Yes No
If yes, please list price range, housing type, and location (if known)_________________________________________________
_________________________________________________________________________________________________________

College Credit: Will you be seeking college credit for the program? Yes No
If yes, institution:________________________________

How did you hear about the program?
Friend/family
E-mail
career counselor
Hotjobs.com
Monster.com
JobPostings.net/com
on-campus information session
Internet search
fellow (or former) intern in the program
Recruiter:______________________________ Other:__________________________________________

** Date you would like to start the internship______________________________
** Date you would like to end the Internship_______________________________

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Program Costs
$1,000   Deposit (applied to tuition)
$1,400   At the time of placement
$1,000   Paid one week prior to start of internship and seminar

I have reviewed the above information, and it is true and complete to the best of my knowledge. (This application cannot be processed without your signature.)

Signature:________________________________________________      Date:_____________________________________________


Direct inquiries to:
Washington Internship Program
Attention: Dr. Linda Bayer
7606 16th Street , N.W.
Washington, D.C. 20012
(202) 829-5364

Leave name and phone number; all calls will be returned by Washington Internship staff.
Rolling admission: applications will be processed in the order received. Prospective interns are encouraged to apply early.