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Andrus Center for Public Policy
Form Test
Form Test
John Freemuth Student Congress
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
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Montana
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New Hampshire
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New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Date of Birth -- / -- / ----
College or University you are attending
(Required)
Academic Standing
(Required)
Junior (earned 60-89 credit hours)
Senior (earned more than 90 credit hours)
Masters-level graduate student
Please list your current major(s):
(Required)
Please list your current minor(s):
Cumulative GPA
Future plans/career aspirations
(Required)
(250 words or less)
What do you hope to gain from your participation in this program:
(Required)
(250 words or less)
How did you hear about this opportunity?
Essay
(Required)
Accepted file types: pdf, doc, docx, jpg, Max. file size: 50 MB.
In an essay of less than 500 words, please describe your interest in public lands and fire management. Be sure to address what unique perspective you personally would bring to these topics and why. The essay should address the origins of your personal interest in and commitment to the well-being of public lands and the citizens who care about them.
Maximum file size - 50 mega bytes.
Name of Reference
First
Last
Email of Reference
Phone number of reference
Applicant Agreement
(Required)
I have read and accept the Applicant Agreement
To the best of my knowledge and belief, there is no reason that would prevent me from being eligible to receive the John Freemuth Student Congress nomination. The Andrus Center for Public Policy has my permission to share my academic information and documents with governmental and university auditors for purposes of verifying my eligibility. I understand that in order to be eligible for this opportunity, I must be enrolled at the aforementioned school or university and continue to meet all guidelines. I understand that incomplete applications submitted without all required attachments and supporting information will not be forwarded to the selection committee for program consideration.I hereby affirm that the above information I have provided is true and correct to the best of my knowledge. I also consent that if chosen, my picture may be taken and used to promote the program. (Photo requirement may be waived by the selection committee for compelling circumstances.) I have read and accepted the above statement.
Signature - Type your name here
(Required)
Name
Date of Signature -- / -- / ----