Internships Applicant's Contact Information First Name* MI Last Name* Street Address* Street Address Continued City* State* ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip Code* Email* Telephone Number* Telephone Type VoiceVPTTD What are these options? Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone. Applicant's Additional Information Date of Birth* Where would you like to work? (check all that apply): District OfficeWashington DC Office What semester are you applying for? (check all that apply): FallSpringSummerWinter Permanent Address (if different) Street Address Street Address Continued City State ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY Zip Code Emergency Contact Information Emergency Contact Name* Emergency Contact Telephone Number* Emergency Contact Telephone Type VoiceVPTTD Skills applicable to internship List specific issues and areas of interest to you: Have you served a prior internship in Washington D.C. or in a district office? If yes, with whom? Academic Information Schools attended, beginning with your current school:* If you are currently enrolled in college/university, please answer the following: Is academic credit available for internships? Is academic credit available for internships? YesNo Years in School Graduation Date GPA Major Activities/Honors Career Objectives Advisor's Name* Names and Addresses of Three References Please use this box to write a brief paragraph about yourself, including the reasons why you would like to intern in a congressional office. Applicant's Cover Letter and Resume: Cover Letter Resume Your file size can not exceed 500KB. Documents must be the following file types: .doc, .docx, .pdf, .rtf, .txt Macintosh users: Your document must have a file extension. Resave it using your word processor with the appropriate extension from the above list. Office of US Congresswoman Bustos Internship Scholarship Program The Office of US Congresswoman Bustos created a scholarship program to provide access to our internship programs to applicants who cannot afford to work without pay or who cannot otherwise afford the living expenses of Washington DC. Scholarships are limited to applicants who currently reside in the 17th Congressional District of Illinois or who have previously spent significant time residing in the 17th Congressional District of Illinois. Scholarships are also reserved for interns who are able to work full-time (40 hours per week). Applicants receiving funding through a third party program such as a university or nonprofit are not eligible for the scholarship program. The Office of US Congresswoman Bustos Scholarship Program is intended for those who could not otherwise participate in a full-time, unpaid internship. The office considers a financial need to exist in specific circumstances such as: when an individual is eligible for a Pell Grant; when an individual or a person claiming the individual as a dependent is eligible for an Earned Income Tax Credit; when an individual or person claiming the individual as a dependent has an income at or below the federal poverty line; and other similar circumstances that may make an individual decline to accept an internship offer because the individual could not otherwise offered to intern with the Office. Veterans and others receiving Social Security disability payments are also considered eligible for the program. The Office can only provide a limited number of paid scholarships for individuals with demonstrated need. The office therefore requests that you do not ask for this certification if you do not have such need. Acceptance to the internship program is not a guarantee of funding. All internship applications will be evaluated independently from your certification of financial need. Do you certify that you have a financial need for this scholarship and that you could not otherwise afford an unpaid internship?* ---YesNo Do you certify that you will not receive outside funding for your internship, such as funding from an educational institution, nonprofit or other third-party internship program? Note: Scholarship recipients may still earn academic credit, but not outside financial assistance for the internship.* ---YesNo Pursuant to federal law, scholarship recipients must be eligible to receive pay from the Federal government. If selected for a scholarship, could you truthfully certify one of the following: (1) You are a United States citizen; or (2) You are lawfully admitted for permanent residence and are seeking citizenship as outlined in 8 U.S.C. § 1324b(a)(3)(B); or (3) You are (i) admitted as a refugee under 8 U.S.C. § 1157 or granted asylum under 8 U.S.C. § 1158 and (ii) you have filed a declaration of intention to become a lawful permanent resident and then a citizen when eligible; or (4) you owe allegiance to the United States under the law. (Note: To meet the “owe allegiance” requirement, an individual must be (1) a non-citizen U.S. national born in or having ties to American Samoa or Swains Island (as outlined in 8 U.S.C. § 1408), or (2) a non-citizen U.S. national pursuant to section 302 of Public Law 94-241 (relating to the Commonwealth of the Northern Mariana Islands)). ---YesNo Please note that the law requires the Office to comply with the E-Verify Program established by the Department of Homeland Security (DHS) and the Social Security Administration (SSA). If you are selected for a scholarship, the Office will verify that you are eligible for employment in the United States. In pursuing your educational goals, what challenges have you faced and how have you overcome them? In answering these questions, please explain why you are applying for the Office of Congresswoman Bustos Scholarship Program, which is intended for those with financial need, and how you believe this internship will further your educational goals. (500 word maximum)
