Eastern Michigan University
Department of Political Science
APPLICATION FOR POLITICAL SCIENCE/PUBLIC ADMINISTRATION INTERNSHIP PROGRAM
Name_____________________________ Date Submitted: ______________________
Student Number _____________________ Class Level________________________
Major_____________________________ Graduation Date_____________________
Minor______________________________ Social Security# ___________________
Local Address________________________________________________________
Permanent Address_____________________________________________________________
Local Home Phone______________ Local Work Phone_______________
Permanent Home Phone_______________ Email address:___________________________________
TYPE OF INTERNSHIP IN WHICH YOU ARE INTERESTED
___ Legislative ___ Legal ___ Administrative
Other: _______________________________________________________________
______________________________________________________________________
List courses, instructors, and grades in Political Science/Public Administration courses you have completed.
Courses
Instructor
Grade
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What specialized skills or related work experience, if any, do you have? (e.g., accounting, writing, computer
experience, etc.)
What "political", "public administration", or similar experience have you had?
What are your career plans/goals?
What personal learning objectives do you expect to meet through an internship?
Overall G.P.A. ________
Are you willing to travel to a position? Y/N ____ How far? ______
How many hours each week are you willing to devote to an internship? ________
Do you qualify for College Work Study funds? Y/N _________
During what semester do you wish to intern? (sem/yr) _________
REFERENCES. Please list three faculty members and/or former employers who are familiar with your work.
You need not furnish written recommendations, but the people you list may be contacted.
On a separate page, please explain why you think an internship would be of value to you and the reasons for
thinking you would be a good candidate for such a position. Add any other information which will help us
evaluate your candidacy. Indicate the kind of placement or agency in which you are interested. Return
application to Dr. Raymond Rosenfeld, Department of Political Science, 601 Pray-Harrold.
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