Applicant Information Last Name First Name M.I. Date Street Address Apartment/Unit # City State Zip Code Contact Number Contact Email I am interested in applying for the: (select one) Fall Semester Spring Semester Summer Semester Date Beginning: I am interested in applying for an internship in the: (select one) Ventura District Office Santa Barbara District Office Have you ever worked for a State or Federal office? Yes No If yes, when? Leave this field blank