Congressional Award Ambassador Application

Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Race/Ethnicity

Please type in your racial/ethnic identity. If you prefer not to provide this information simply type "I do not wish to provide this information."
Gender Identity

Gender identity is one's personal sense of their own gender. Common examples include: Male/Man, Female/Woman, Gender Non-Conforming, Transgender, etc. Please type in your gender identity or type "I do not wish to provide this information" if you prefer not to.
Disability
- I have a disability.
- I do not have a disability.
- I prefer not to answer
Disability - Continued

Please let us know what your disability is. If you would rather not, please type "I do not wish to provide this information."
First-Generation/Second-Generation Status
- I am a foreign-born immigrant to the United States (first-generation immigrant).
- My parent(s) are foreign-born immigrant(s) to the United States (second-generation American).
- I am the first person to reach my current level of education in my family (e.g., first-generation college student/grad)
- I prefer not to answer/None of these apply to me.
Please check any that apply to you.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Primary Phone
Secondary Phone
Your Congressional Award*

What's the highest award level you've earned and in what year did you earn it?
Name When Award Was Earned (if different - maiden, etc.)
First Last
Upload Your Cover Letter*
Drop files here or

Max. file size: 300 MB, Max. files: 3.
Upload your resume if you would like us to know more about your interests and talents.
Upload Your Resume*
Drop files here or

Max. file size: 300 MB, Max. files: 3.
Upload your resume if you would like us to know more about your interests and talents.
Additional Notes
Is there anything else we should know about your candidacy?
CAPTCHA

Congressional Award Ambassador Application

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