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SEAN-MICHAEL MILES FELLOWSHIP APPLICATION **This application must be printed out.** Please
type or print all answers. In addition, please attach a recent writing
sample and two letters of recommendation. Max
Baucus
Name:____________________________________________________________ Social Security #:___________________________________________________ Temporary Address:_________________________________________________ _________________________________________________________________ Phone:____________________________________________________________ Permanent Address:_________________________________________________ _________________________________________________________________ Have you ever been a Congressional Intern? Yes______ No______ If yes, list offices and dates:___________________________________________ _________________________________________________________________ Have you ever
been convicted of a felony? _________________________________________________________________ Education High School Name:___________________________________________________ Address:___________________________________________________________ University:__________________________________________________________ Location (city, state):__________________________________________________ Dates of Attendance:__________________________________________________ Date of Graduation:___________________________________________________ Anticipated Graduation
Date:_______________
Cumulative GPA:_____________ Outstanding Achievements:_____________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Please answer the following questions and attach to this form: 1) Why do you seek this particular fellowship? 2) What qualities do you have that you feel qualify you for this position? |