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10/21/2019

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Registration

Brief Bio � Describe yourself in 250 characters of less:*

First name

Last name

City

State

Middle name

Positions of interest, check all that apply:*

Case Worker

Chief of Staff

Communications Director

Counsel/Advisor

Digital Assistant

Digital Director

District Director

Intern

Legislative Assistant

Legislative Correspondent

Legislative Director

Press Secretary

Scheduler

Staff Assistant

Systems Administrator Type of office that you are interested in working for:

Blue Dog Office

Committee Office

Congressional Asian Pacific American Caucus Office

Congressional Black Caucus Office

Congressional Hispanic Office

Congressional Progressive Caucus Office

Leadership Office

LGBT Caucus Office

New Dem Office How soon are you available to begin employment?*

Immediately

2 weeks

1 month

3 months or more Do you have any previous experience working for a Member of Congress?*

Or:

I am currently working for a Member of Congress Previous positions on the Hill: check any that apply:

Case Worker

Chief of Staff

Committee Staff

Communications Director

Counsel / Advisor

Digital Assistant

Digital Director

District Director

Intern

Legislative Assistant

Legislative Correspondent

Legislative Director

Press Secretary

Scheduler

Staff Assistant

Systems Administrator

Other Issue areas where you have legislative experience (select up to eight):

Agriculture

Appropriations

Armed Services

Budget

Civil Rights

Education

Energy/Environment

Finance

Foreign Affairs

HealthCare

Homeland Security

Housing

Intelligence

Judiciary

Labor

Natural Resources

Science

Small Business

Taxes

Tech/Telecom

Trade/Economy

Transportation

Veterans Committees that you have legislative experience working with:

Agriculture

Appropriations

Armed Services

Budget

Education and the Workforce

Energy and Commerce

Ethics

Financial Services

Foreign Affairs

Homeland Security

House Administration

Intelligence

Judiciary

Natural Resources

Oversight and Government Reform

Rules

Science, Space, and Technology

Small Business

Transportation and Infrastructure

Veterans' Affairs

States with connections (select up to three):

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Virginia

Vermont

Washington

West Virginia

Wisconsin

Wyoming

American Samoa

District of Columbia

Guam

Northern Mariana Islands

Puerto Rico

Virgin Islands Issue areas of interest, check any that apply:

Agriculture

Appropriations

Armed Services

Budget

Civil Rights

Education

Energy/Environment

Finance

Foreign Affairs

Health Care

Homeland Security

Housing

Intelligence

Judiciary

Labor

Natural Resources

Science

Small Business

Taxes

Tech/Telecom

Trade/Economy

Transportation

Veterans Level of education, check any that apply:

High School

Master's degree

PhD

Associate degree

Bachelor's degree

Other postgraduate degree Languages proficient in other than English, check any that apply:

Spanish

Tagalog

Korean

Portuguese

Cantonese

Mandarin

Vietnamese

Russian

Polish

Greek

French

German

Italian

Japanese

Other Have you performed military service?

Select an option

I am currently serving Have you served in the Peace Corps, AmericCorps, Teach for America, or a similar program of service?

Select an option

Or:

I am currently serving Do you hold a federal security clearance that is either active or eligible for reactivation?

Select an option

- None - Confidential Secret Top Secret Check any that apply:

Currently active

SCI

Q Optional Demographic Information (check all that apply):

Male

White/Caucasian

Asian

Female

Black/African-American

Native Hawaiian or other Pacific Islander

LGBT

Hispanic/Latino

Native American

Other Political Party (optional):

Democrat

Republican

Please choose a single PDF or DOC file that contains a cover letter, resume, and professional references. Were you given a unique code from a House Democratic Office to tie your resume to a specific job opening or resume list?

Data Name	Data Type	Options
Brief Bio � Describe yourself in 250 characters of less:*	Text Box
First name	Text Box
Last name	Text Box
Email	Text Box
City	Text Box
State	Text Box
Middle name	Text Box
	checklist	Positions of interest, check all that apply:*
	checklist	Case Worker
	checklist	Chief of Staff
	checklist	Communications Director
	checklist	Counsel/Advisor
	checklist	Digital Assistant
	checklist	Digital Director
	checklist	District Director
	checklist	Intern
	checklist	Legislative Assistant
	checklist	Legislative Correspondent
	checklist	Legislative Director
	checklist	Press Secretary
	checklist	Scheduler
	checklist	Staff Assistant
	checklist	Systems Administrator Type of office that you are interested in working for:
	checklist	Blue Dog Office
	checklist	Committee Office
	checklist	Congressional Asian Pacific American Caucus Office
	checklist	Congressional Black Caucus Office
	checklist	Congressional Hispanic Office
	checklist	Congressional Progressive Caucus Office
	checklist	Leadership Office
	checklist	LGBT Caucus Office
	option	New Dem Office How soon are you available to begin employment?*
	option	Immediately
	option	2 weeks
	option	1 month
	option	3 months or more Do you have any previous experience working for a Member of Congress?*
	option	No
	date
	date
	checklist	Or:
	checklist	I am currently working for a Member of Congress Previous positions on the Hill: check any that apply:
	checklist	Case Worker
	checklist	Chief of Staff
	checklist	Committee Staff
	checklist	Communications Director
	checklist	Counsel / Advisor
	checklist	Digital Assistant
	checklist	Digital Director
	checklist	District Director
	checklist	Intern
	checklist	Legislative Assistant
	checklist	Legislative Correspondent
	checklist	Legislative Director
	checklist	Press Secretary
	checklist	Scheduler
	checklist	Staff Assistant
	checklist	Systems Administrator
	checklist	Other Issue areas where you have legislative experience (select up to eight):
	checklist	Agriculture
	checklist	Appropriations
	checklist	Armed Services
	checklist	Budget
	checklist	Civil Rights
	checklist	Education
	checklist	Energy/Environment
	checklist	Finance
	checklist	Foreign Affairs
	checklist	HealthCare
	checklist	Homeland Security
	checklist	Housing
	checklist	Intelligence
	checklist	Judiciary
	checklist	Labor
	checklist	Natural Resources
	checklist	Science
	checklist	Small Business
	checklist	Taxes
	checklist	Tech/Telecom
	checklist	Trade/Economy
	checklist	Transportation
	checklist	Veterans Committees that you have legislative experience working with:
	checklist	Agriculture
	checklist	Appropriations
	checklist	Armed Services
	checklist	Budget
	checklist	Education and the Workforce
	checklist	Energy and Commerce
	checklist	Ethics
	checklist	Financial Services
	checklist	Foreign Affairs
	checklist	Homeland Security
	checklist	House Administration
	checklist	Intelligence
	checklist	Judiciary
	checklist	Natural Resources
	checklist	Oversight and Government Reform
	checklist	Rules
	checklist	Science, Space, and Technology
	checklist	Small Business
	checklist	Transportation and Infrastructure
	checklist	Veterans' Affairs
	checklist	States with connections (select up to three):
	checklist	Alabama
	checklist	Alaska
	checklist	Arizona
	checklist	Arkansas
	checklist	California
	checklist	Colorado
	checklist	Connecticut
	checklist	Delaware
	checklist	Florida
	checklist	Georgia
	checklist	Hawaii
	checklist	Idaho
	checklist	Illinois
	checklist	Indiana
	checklist	Iowa
	checklist	Kansas
	checklist	Kentucky
	checklist	Louisiana
	checklist	Maine
	checklist	Maryland
	checklist	Massachusetts
	checklist	Michigan
	checklist	Minnesota
	checklist	Mississippi
	checklist	Missouri
	checklist	Montana
	checklist	Nebraska
	checklist	Nevada
	checklist	New Hampshire
	checklist	New Jersey
	checklist	New Mexico
	checklist	New York
	checklist	North Carolina
	checklist	North Dakota
	checklist	Ohio
	checklist	Oklahoma
	checklist	Oregon
	checklist	Pennsylvania
	checklist	Rhode Island
	checklist	South Carolina
	checklist	South Dakota
	checklist	Tennessee
	checklist	Texas
	checklist	Utah
	checklist	Virginia
	checklist	Vermont
	checklist	Washington
	checklist	West Virginia
	checklist	Wisconsin
	checklist	Wyoming
	checklist	American Samoa
	checklist	District of Columbia
	checklist	Guam
	checklist	Northern Mariana Islands
	checklist	Puerto Rico
	checklist	Virgin Islands Issue areas of interest, check any that apply:
	checklist	Agriculture
	checklist	Appropriations
	checklist	Armed Services
	checklist	Budget
	checklist	Civil Rights
	checklist	Education
	checklist	Energy/Environment
	checklist	Finance
	checklist	Foreign Affairs
	checklist	Health Care
	checklist	Homeland Security
	checklist	Housing
	checklist	Intelligence
	checklist	Judiciary
	checklist	Labor
	checklist	Natural Resources
	checklist	Science
	checklist	Small Business
	checklist	Taxes
	checklist	Tech/Telecom
	checklist	Trade/Economy
	checklist	Transportation
	checklist	Veterans Level of education, check any that apply:
	checklist	High School
	checklist	Master's degree
	checklist	PhD
	checklist	Associate degree
	checklist	JD
	checklist	Bachelor's degree
	checklist	MD
	checklist	Other postgraduate degree Languages proficient in other than English, check any that apply:
	checklist	Spanish
	checklist	Tagalog
	checklist	Korean
	checklist	Portuguese
	checklist	Cantonese
	checklist	Mandarin
	checklist	Vietnamese
	checklist	Russian
	checklist	Polish
	checklist	Greek
	checklist	French
	checklist	German
	checklist	Italian
	checklist	Japanese
	option	Other Have you performed military service?
	option	No
	dropdown	Select an option
	dropdown	Select an option
	date
	date
	checklist	OR
	option	I am currently serving Have you served in the Peace Corps, AmericCorps, Teach for America, or a similar program of service?
	option	No
	dropdown	Select an option
	date
	date
	checklist	Or:
	option	I am currently serving Do you hold a federal security clearance that is either active or eligible for reactivation?
	option	No
	dropdown	Select an option
	checklist	- None - Confidential Secret Top Secret Check any that apply:
	checklist	Currently active
	checklist	SCI
	checklist	Q Optional Demographic Information (check all that apply):
	checklist	Male
	checklist	White/Caucasian
	checklist	Asian
	checklist	Female
	checklist	Black/African-American
	checklist	Native Hawaiian or other Pacific Islander
	checklist	LGBT
	checklist	Hispanic/Latino
	checklist	Native American
	option	Other Political Party (optional):
	option	Democrat
	option	Republican
	file
	option	Please choose a single PDF or DOC file that contains a cover letter, resume, and professional references. Were you given a unique code from a House Democratic Office to tie your resume to a specific job opening or resume list?
	option	No
	checklist
	checklist