INTERNSHIPS IN THE OFFICE OF SENATOR GILLIBRAND

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INTERNSHIPS IN THE OFFICE OF SENATOR GILLIBRAND Senator Gillibrand s Senate internship program provides an excellent opportunity for students to learn and serve through first-hand participation in government service, and the legislative process. The program is intended to provide participants with the tools, skills, and experience that they can readily apply to future challenges and professional pursuits. We expect a great deal from our interns. Candidates will have a diverse, challenging experience and make a genuine contribution to Senator Gillibrand s work on behalf of New York and the nation. Candidates are often students and recent graduates of all levels, from high-school, to undergraduates, graduate school and law school. We welcome all applicants who have demonstrated academic excellence and have displayed a commitment to public service. While preference is given to New York residents, students from all backgrounds are encouraged to apply. THE APPLICATION PROCESS Please complete all sections of the application thoroughly. Although providing the information requested is voluntary, failure to provide complete answers may affect the review and consideration of your application. Your application must include all of the following in order to be considered: Internship Application Form Current Resume One page cover letter describing why you want to be an intern in the Office of Senator Gillibrand and what you would bring to the office Writing sample (No strict requirements, other than that it should show your ability to communicate and concisely express ideas in 2-4 pages.) Two References: please include name, title, email address, and telephone number A transcript may be requested. Unofficial transcripts are OK. The application and requested materials should be submitted together via the means submitted below. Given the volume of incoming applications, we will not be able to return any of the materials we receive. Failure to meet any of the above-mentioned requirements may delay, or even prevent, the review of your application.

FAX OR E-MAIL COMPLETE APPLICATIONS TO: Candidates should submit complete applications to the office where they wish to intern by facsimilie or e-mail ( for the Washington, DC Office and NYC office applications for all other office should be faxed). If you are applying to multiple offices, please send an application to every office to which you re applying. Contact information for each of Senator Gillibrand s offices is shown below: Washington, D.C. Office New York City Office Tel. 202-224-4451 Fax 202-224-1560 Tel. 212-688-6262 Fax 212-688-7444 Gillibrand_Internship@gillibrand.senate.gov Gillibrand_InternshipsNYC@gillibrand.senate.gov Albany/Capital District Office Buffalo Office Leo W. O Brien Federal Office Building Larkin At Exchange 1 Clinton Square, Room 821 726 Exchange Street, Suite 511 Albany, NY 12207 Buffalo, NY 14210 Tel. 518-431-0120, Fax 518-431-0128 Tel. 716-854-9725, Fax 716-854-9731 Long Island Office Rochester Office 155 Pinelawn Road Kenneth B. Keating Federal Office Building Suite 250 North 100 State Street, Room 4195 Melville, NY 11747 Rochester, NY 14614 Tel. 631-249-2825, Fax 613-249-2847 Tel. 585-263-6250, Fax 585-263-6247 Syracuse/Central New York Office James M. Hanley Federal Building 100 South Clinton Street, Room 1470 PO Box 7378 Syracuse, NY 13261 Tel. 315-448-0470, Fax 315-448-0476

SESSION DATES AND APPLICATION DEADLINES: FALL/WINTER SESSION 2012 (August End of December) NYC: Applicants will be admitted on a rolling basis. SPRING SESSION 2011 (January May ): NYC: Applicants will be admitted on a rolling basis. It is recommended to submit your application before November 15, 2011. SUMMER SESSION 2012 (May-August) Deadline is March 19, 2012 Applications must be e-mailed or faxed by the deadline date for each session. Notification about the status of your application will be e-mailed to you. FUNDING Please note that all internships are unpaid. However, candidates are permitted under Senate Rules to apply for and accept financial assistance from appropriate outside sources. Nonetheless, Senate Rules allow that receipt of financial assistance from outside sources does not create a conflict of interest with your Senate work. Please indicate in the space provided on the application if you plan to receive funding from an outside source. ACADEMIC CREDIT Awarding academic credit for an internship is at the discretion of your college or university. However, we will assist you in providing appropriate information as requested by your school. Arrangements for accreditation should be made before you begin the internship.

PERSONAL INFORMATION: SENATOR KIRSTEN GILLIBRAND INTERNSHIP APPLICATION FORM -Plea se type or print legibly- Full Name Last First Middle Initial Today s Date: Place of Birth City State Date of Birth / / Current Phone ( ) - Home Phone ( ) - Current (School) Address Permanent Address E-mail address: _ Prior Political/Government Experience: Areas of Interest (Please be as specific as possible): How did you hear about Senator Gillibrand s Internship Program? Have you applied to this internship before? If so what office/season?: Yes No

ACADEMIC INFORMATION: Are you currently a student? Yes No If yes, please select one: High School College/University Graduate/Law If no, please select highest degree completed: High School College/University Graduate/Law Year of Graduation: GPA: Major: INTERNSHIP INFORMATION: Please rank your preferences in internship location: Washington D.C. Buffalo New York City Long Island Albany Syracuse Rochester Please check the session for which you are applying: Fall/Winter 2011 Spring 2012 Summer 2012 Please note that Summer Sessions in D.C. are divided into two separate sessions. D.C. Summer Session I runs from around the middle of May until the end of July. D.C. Summer session II runs from the beginning of July until the middle of August. If you are applying to the D.C. office please indicate which session you would prefer. If you are willing to intern during either session you may check off both. D.C. Summer Session I D.C. Summer Session II

Please note the range of time [earliest/latest date] you are available to take part in the internship program: to. Please circle: part-time or full-time (Senator Gillibrand s office is open 9AM-6PM) If part-time or for current students, please detail the availability of your schedule: Monday: Tuesday: Wednesday: Thursday: Friday: Note: Interns are expected to make a commitment of at least 20 hours per week during the Academic Semester. Summer Programs are full time Department Preferences: Please rank the departments in the order in which they interest you: 1=highest, 3=lowest Within Constituent Affairs, please rank the casework issues in the order in which they interest you (1=highest, 5-lowest) Within outreach please check off all areas of interest Constituent Affairs: Immigration and Foreign Affairs Veterans, Military, Service Academy Nominations, Taxes, Prisons, Postal Services, Civil Rights Healthcare, Social Security, Education, Social Services Labor, Small Business, Housing, Banking, Consumer Affairs, Environment, Transportation, Legal Outreach: Economic Development Faith-Based Identity groups Arts /Education Borough outreach Women LGBTQ Seniors Labor Operations (Scheduling): Press Office:

SECURITY QUESTIONS: Please answer all questions in full candor and detail. Have you ever had disciplinary or administrative actions (i.e. suspensions, probation, expulsion) been taken against you by your school or are any pending? Yes No Have you ever been charged with or convicted of any criminal offense, DWI/DUI, or misdemeanor offense? Yes No Have you ever used, possessed, supplied, or manufactured any illegal drugs? Yes No If you answered Yes to any of the above questions, please provide an explanation and include the dates of the actions on a separate page. CERTIFICATION My statements on this form and any attachments to it, are true complete and correct to the best of my knowledge and belief and are made in good faith. I understand that knowingly giving false information will lead to the rejection of my application and/or immediate dismissal from the program Signature Date