Internship Application

Please feel free to print this application and send it to my Washington office. 

Please attach resume, a writing sample of 1-3 pages, and at least one recommendation and return to the Washington, DC office.

NAME: ______________________________________ DATE OF BIRTH: ____________

PERMANENT ADDRESS: _____________________________________________________

_________________________________________ PHONE: _______________________ 

SCHOOL ADDRESS:_________________________________________________________ 

_________________________________________ PHONE:________________________

COLLEGE/UNIVERSITY ENROLLED:____________________________________________ 

YEAR IN SCHOOL:_________________________________________________________ 

MAJOR/MINOR:_______________________________ GPA:________________________ 

WILL YOU RECEIVE COLLEGE CREDIT? _______________________________________ 

DATES AVAILABLE FOR INTERNSHIP:_________________________________________ 

HOURS PER WEEK (15 minimum):____________________________________________ 

AREA OF LEGISLATIVE INTEREST: __________________________________________

IN CASE OF EMERGENCY CONTACT: __________________________________________

________________________________________________________________________

SOCIAL SECURITY NUMBER: ________________________________________________

SIGNATURE ________________________________ DATE ________________________ 

Mail to:

Internship Program
Office of Senator Ken Salazar
United States Senate
Washington, D.C. 20510-3903