Application Deadline for Autumn Quarter 2009 is Wednesday, May 20.
Applications must be complete and include all attachments in order to be submitted. If you have any questions about this document or the application process, please contact the on-campus program coordinator, Mr. Chris Adams, at Adams.615@osu.edu or 614-247-2512. Please note: Required fields are designated with an asterisk (*).
Address *
Apt./Suite
Phone * ( ) -
Alternate Phone: ( ) -
Name* Relationship*
Major(s): *
Minor(s):
Cumulative GPA *
Expected quarter of graduation: Winter 10 Spring 10 Summer 10 Autumn 10 Winter 11 Spring 11 Summer 11 Autumn 11 Winter 12 Spring 12 Summer 12
Letters of recommendation should be mailed directly to:
The Selection Committee Washington Academic Internship Program 110 Page Hall 1810 College Road Columbus, OH 43210
Recommendation letters from two sources. At least one should be from a faculty member, instructor, or teaching assistant who can evaluate your academic preparation for this program. Letters should be on letterhead when possible, signed, and addressed to the Selection Committee, Washington Academic Internship Program. If a written letter of recommendation is not obtainable, then an email from the recommender will be accepted.
Please note: Letters of recommendation may be submitted electronically by e-mail to Mr. Chris Adams, adams.615@osu.edu. Letters may also be submitted via fax to 614.292.2548.
Please give an indication of the substantive area(s) in which you would desire an internship. What policy concerns would you like to explore while in Washington?
It is highly recommended that students investigate potential internship sites and include this information in their applications.
Before completing this section, please read the section on Internships. You may then indicate below the organizations with which you would desire an internship. If you have contacted the organization’s internship coordinator, please provide the contact information and any notes on your status.
Organization Name
Contact full name
Contact phone
Contact e-mail Notes:
Among the information to be provided: academic awards, honors, or fellowships received, employment history, examples of public service, extracurricular activities, language and computer skills, etc. Please limit to one page.
Attach Résumé Here *
Indicate (in two pages, double-spaced):
Attach Personal Statement *
A writing sample that demonstrates your analytical ability and shows your writing skills to best advantage. The sample should be pertinent to your area of general policy interest and should be no more than five pages (typed, double-spaced). If the sample is drawn from a larger paper, give the context of the excerpt.
Writing Sample *
Many internship placements in Washington, D.C. require a criminal background check, security clearance, drug testing, or other security measures. This is particularly true for positions in the Federal government and several Congressional offices. In order to approach prospective internship placements with transparency, please answer the following questions. An affirmative response to the questions listed below does not necessarily eliminate you from consideration for the program. The information will be used to help identify the most appropriate internship location for you, as well as contribute to our assessment about your eligibility for the program.
Have you ever been disciplined in any way for any matter by Ohio State or any college, university, or other institution of higher learning? If so, please explain.
Are you currently under indictment or have you ever been convicted of any offense, placed on probation, or granted deferred adjudication or any type of pretrial diversion? If so, please explain.
(You may exclude misdemeanor traffic violations.)
Have you ever been arrested, cited or ticketed for, or charged with any violation of the law? If so, please explain.
I certify that the answers on this document are true, to the best of my knowledge. I realize that any misrepresentations of facts may constitute cause for discontinuance in the selection process. I authorize all references to cooperate with the university and to release, on a confidential basis, any information concerning my candidacy, and further authorize The Ohio State University access to my academic records.
* By checking this box, you agree to the above terms and conditions.
