Commonwealth Compact Collaborative

First Name *
Middle Name
Last Name *
Cell phone
Email address *
Secondary Phone *
Please enter your month of birth *
Current Address 1 *
Current Address 2 *
City
State *
Zip *
Permanent Address 1 *
Permanent Address 2 *
City *
State *
Place of Birth (City, State, Country):
Please select the category that best applies to you: *	At the time of placement, I will have completed my freshman year. At the time of placement, I will b enrolled as a graduate student.
Are you authorized to work in the United States on an unrestricted basis? *	Yes No
Are you fluent in any language other than English? *	Yes No
List of proficient foreign languages (please separate with a comma): *
Favorite place to visit: *
Favorite song *
Favorite sports team *
Hobbies *
Have you held a leadership position among your peers and colleagues? *	Yes No
Goals for Fellowship
Goals for your education *
Goals for your Career *
Other life goals *
College/University *
School Type *	Public Private
Major *
Graduation/Expected Graduation Date (MM/YYYY): *
Graduate Studies : College/University:
School Type: *
Graduation/Expected Graduation Date: (MM/YYYY)
Have you served in the US Military? *	Yes No
From *
Branch *
To *
Computer skills: *	HTML (basic) HTML (advanced) Microsoft Access Blogging Website Design Database Management Microsoft Excel (basic) Microsoft Excel (advanced)
Are you receiving academic credit for this internship: *	Yes Unsure/maybe No
Policy Areas of Interest *
General Skills (Select three attributes you feel describe you best. Do not pick more than three *	Organized Works well under pressure Quick learner Motivated Self-starter Works well in Teams Excellent Oral Communication Skills Excellent Written Communication Skills Multitasker Strong Research Skills Strong Legal Writing Skills
Professional Experience (activities you have undertaken as part of a job, internship or student group): *	Speechwriting Article/column/news writer Editor Customer Service Scheduling/Advance Office Management Community/Issue/Political Organizing Data Analysis Human Resources Event Planning Graphic Design New Media Memo Writing Data Entry Other
Essay Questions (Please respond in 300-500 words for the essay chosen, choose only one): (a)Explain your commitment to public service and include an instance when you asserted your leadership in a community or civic activity, what you learned, and how y *
(b)Explain your commitment to public service and discuss how it shaped your career goals or helped cultivate skills that have proven valuable in the workplace. We will accept PDF, doc, docx, and txt files:
Please submit your resume below. We will accept PDF, DOC, DOCX, and TXT files. Please ensure your resume is not more than two pages in length. *
Please provide an email address for each person who will be submitting a recommendation for you. They will receive a special link that will direct them to the recommendation form. *
Gender identification? *
Race identification: ** Please check one	Asian/Pacific Islander Black Latino/Hispanic Native American White Other
How did you hear about the Commonwealth Diversity Fellows Program? *	__Through a CDFP Fellow Alum __Media Coverage __Website – Commonwealth Compact __Website – UMASS-Boston __Attended an outreach event __Friend/Colleague __Marketing materials __From faculty and/or staff __Other
Areas of Interests: • List your top FIVE areas of interest:
Computer Skills: Select all that applies: *	HTML (advanced) HTML (basic) Access (basic) Access (advanced) Excel (basic) Excel (advanced) PowerPoint (basic) PowerPoint (advanced) Publisher (basic) Publisher (advanced) InfoPath (basic) InfoPath (advanced) Blogging Website Design Database Management
General Skills: Please select only three (3) attributes that describe you best: *	Organized Works well under pressure Quick learner Motivated Self-starter Works well in Teams Multitasker Strong Research Skills Strong Legal Writing Skills Excellent Oral Communication Skills Excellent Written Communication Skills
Professional Experience: activities you have undertaken as part of a job, internship or student group: (examples are: scheduling, data entry, speech writing, community organizing)
Have you held a leadership position among your peers and colleagues? *
What were your accomplishments?
What were your challenges: *
Name some of the lessons learned: *
Essay Questions: *
Write a professional policy memo for a senior staffer in a department where you would like to intern. The memo should address a topic that you are particularly passionate or knowledgeable about. Please submit in one of the following formats: PDF, DOC, DO *
Recommendations: Applicants must submit three letters (3) of recommendations. These letters are extremely important, and they should reveal information about you that is not mentioned in your application. Be sure to secure their permission before listin

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