Uni-Capitol Washington
Internship Program (UCWIP)
Student Application Form
Select Monash University students have the opportunity to
apply for a nine week full-time internship with the office of
the US Congress in Washington DC.
Academic study is one of many factors considered.
Paid and voluntary work experiences are also important.
Sophisticated interpersonal skills, resourcefulness and
knowledge are exceptionally important. Critical selection
factors include a free-style essay explaining why this
opportunity is of interest.
UCWIP is competitive and seeks mature, bright, articulate
students who will serve as ambassadors for themselves,
their universities and Australia.
Applicants should be able to demonstrate an understanding
for and an appreciation of the American political process.
Students should hope to benefit from the experience
academically, professionally, and personally.
Students are then asked to rank up to four of the listed
congressional offices and explain why each is of interest.
UCWIP works to find the best ‘match’ taking all these
factors into account.
1. Personal Details
Student number:
Family name:
Given names:
Date of birth:
Mailing address
Nationality:
Mobile:
Home telephone:
Email address:
Emergency contact details
Family name:
Given name:
Mailing address:
Relationship to Applicant:
Mobile:
Home telephone:
Email address:
2. Statement of Purpose
Why do you wish to participate in the program?
Attach a statement outlining why you wish to participate in the UCWIP. This statement should be no more than one page.
Attachment A: Statement of Purpose
3. Preferred Internship Positions
From the list of Placement Participant offices, rank your preferences from first to fourth preference. Explain why you are
interested in each Placement Provider you have selected, in no more than one page for each provider.
Rank
Placement provider
Attachment B, C, D, E
1
2
3
4
4. Monash Education Details
Degree:
Program code:
Managing faculty:
Other faculty:
Expected date of completion:
Current year of study:
Other:
5. Computing Knowledge
Mark ‘3’ if you have experience in any of the following:
Windows OS
Mac OS
Web Publishing
Desktop publishing (e.g. Adobe Creative Suite)
Microsoft Office (including Access and Excel)
SOSS (survey authoring)
Other:
6. Referees
Include two letters supporting your application. Your references should either be from academics, employers or
organisations that can give you a strong character reference. Set out names of the referees below.
Attachment F and G: Character references
Referee one
Title:
Given name:
Last name:
Connection to Applicant:
Company:
Address:
Phone:
Email:
Referee two
Title:
Given name:
Last name:
Connection to Applicant:
Company:
Address:
Phone:
Email:
7. Curriculum Vitae
Attach a detailed CV that lists relevant employment information and relevant experiences, hobbies, memberships, awards
and achievements. The employment information should include: dates of employment, employer details, and type of work
duties. Attachment H: CV
8. Personal Circumstances
Are there any personal circumstances which may prevent you from successfully undertaking any of your preferred
Washington Internship positions (e.g. medical condition or injury, criminal conviction, academic disqualification)? Please
mark “3” in the box below:
Yes:
No:
If yes, please attach details in no more than one page, with any relevant documentation. This information will be treated as strictly confidential, and will
be made known to the Placement Provider only after consultation with you.
It is usual for interns to share a room with other interns in the accommodation organised by the Program. Are there any personal circumstances that
prevent you from sharing a room with other interns? Please mark “X” in the box below:
Yes:
No:
If you have a reason not to share a room, please attach details in no more than one page, with any relevant documentation. This information will be
treated as strictly confidential, and will be held only by the Program Director, for use in planning accommodation and other arrangements.
Monash University will not refer a student to a Washington Internship placement position if the University considers that the student may
place the Placement Provider at risk or act against the interests of the Placement Provider.
9. Faculty Approval
Students should contact the Faculty Exchange Advisor for approval to enrol in the appropriate unit should you
be accepted.
Managing faculty does approve the application and confirms the student’s ability to enrol in the appropriate
research unit
Managing Faculty does not approve this application due to:
Managing faculty:
Name:
Date:
Signature:
10. Supporting documentation
As well as submitting this application form with attachments referred to above, all students applying for a place in the
Uni-Capitol Washington Internship Program must provide:
1. Most recent CV. Attachment H
2. Official Academic Transcript. (this must be purchased from the Student Service Centre or online, a WES print out
is not acceptable) Attachment I
3. An example of written work, no more than 2,000 words. (e.g. an essay or assignment answer) Attachment J
4. Attach an unbound, un-stapled photocopy of the entire application form. Attachment K (old)
Checklist. Please mark “3” in the boxes to indicate you have completed this application and all documents are attached.
Attachment A: Statement of Purpose
Attachment B, C, D, E: Placement explanations
Attachment F and G: Letters of Reference
Attachment H: Most recent CV
Attachment I: Official Academic Transcript
Attachment J: Writing Sample
Attachment K: Unbound photocopy of entire application
11. Statement of Responsibilities and Declaration
Responsibilities of Student Interns
1.Students, whilst engaged in a UCWIP placement, shall be bound by the rules, regulations, protocols and by-laws of the Placement Provider and
Monash University.
2.Standards of dress and behaviour shall be observed and maintained appropriately in keeping with the nature and purpose of the UCWIP
placement.
3.Students will work to fulfil the duties of UCWIP placements within stated times established with the Placement Provider.
4.Students will attend the Washington Internship Orientation Program training before being placed with the Placement Provider.
5.Students will respect the confidentiality of the Placement Provider. No reports in the form of oral, written, graphic or electronic information
pertaining to the Placement Provider or its operations will be made available to any person or company without the consent in writing of the
Placement Provider. If students wish to utilise information gained during the course of Washington Internship Placements after the completion of
the placement, prior consent in writing must be obtained from the Placement Provider, and any material so produced must be approved by the
Placement Provider before release.
6.Students will abide by any agreement made between the parties, and will not undertake any independent negotiations with the Placement
Provider.
7.Students will perform all reasonable requirements of the Placement Provider, and meet all statutory requirements and work place codes of
practice.
8.Students will be responsible for their own travel, accommodation and living expenses whilst in Washington.
9.Students will act with appropriate respect and social maturity in the provided accommodation. No overnight guests will be permitted in the
accommodation at which UCWIP participants are residing without the consent of all students involved. Even then, no guest will be permitted to
stay more than one night.
10.Students will be responsible for the payment of their share of the apartment rent when required by the Program organiser.
Declaration
To the best of my knowledge any information that I have provided on this form is true and correct. I have read the Responsibilities of Interns and agree
to the general conditions outlined in those Responsibilities. I am an Australian citizen. If any liability shall arise to Monash University as a result of my
providing false or misleading information, I agree to indemnify Monash University for any such liability.
I can afford the cost of approximately $9,000 for travel, accommodation and basic living expenses for the duration of the Internship Program.
I understand that an all-inclusive expenditure budget is currently estimated at $13,000.
Applicant’s Signature:
Date:
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