Forms

Commendations and Greetings Form

Note: Fields marked with an * are required.

Prefix *

Ms. Miss. Mrs. Mr. Mr. and Mrs. Rev. Dr. The Honorable Rabbi

First Name *

Middle Initial

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D. and Family

Street Address *

Street Address Continued

City *

State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

Email *

Phone Number *

Phone Type *

Standard telephone device Videophone [VP] Text-telephone device [TTD]

What are these options?

Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone.

First Name of Honoree *

Last Name of Honoree *

Street Address of Honoree *

Honoree's City *

Honoree's State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Honoree's ZIP Code *

Exact Date of Occasion *

Recognition Type *

Appointment to public office Election to public office Awards or honors Citizenship Eagle Scout Gold Star Graduation Heroism Military academy appointment Other achievements of public distinction Presidential Greetings: Birthday (80 years) Presidential Greetings: Anniversary (50 years) Presidential Greetings: Wedding Presidential Greetings: Baby's Birth

Please provide other necessary information

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Community Project Funding Requests

Note: Fields marked with an * are required.

 

Your Contact Information

Prefix

Mr. Mrs. Ms. Dr. Hon. Rev. Rabbi

First Name *

Last Name *

Suffix

Address *

Address (2)

City *

State *

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

E-mail *

Phone Number *

Phone Type *

Voice Videophone [VP] Text-telephone device [TTD]

What are these options?

This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option “Voice” is a normal audible telephone.

Organization Information

Requesting Organization Name *

Organization Head First Name

Organization Head Last Name

Organization Street Address *

City *

State *

MI AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

Address of the Requested Project/Program

Address

City

State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code

Appropriation Request

Project Name

Choose a Subcommittee *

Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Commerce, Justice, Science, and Related Agencies Defense Energy and Water Development Financial Services and General Government Homeland Security Interior, Environment, and Related Agencies Labor Health and Human Services Legislative Branch State, Foreign Operations, and Related Programs Transportation, Housing and Urban Development, and Related Agencies Unknown / not sure

Request Type *

Program Funding Bill Language Report Language

Amount Requested ($)

General Information

Describe the problem or issue to be addressed through this request. Please include as many details as possible and explain why the problem cannot be addressed without the appropriation *

Describe the project or program, what it will do and why it is necessary. Describe the services and projects that will be provided and the reasons for your request *

How does this request benefit MI-09? *

Please include all Congressional members from whom you have requested funding for your program or project *

Provide a brief explanation justifying the request and how it is a good use of taxpayer funds

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Contact

Note: Fields marked with an * are required.

Prefix *

Ms. Miss. Mrs. Mr. Mr. and Mrs. Rev. Dr. The Honorable Rabbi

First Name *

Middle

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D. and Family

Street Address *

Street Address Continued

City *

State *

Zip Code *

Email *

Phone Number *

Phone Type *

Voice Videophone [VP] Text-telephone device [TTD]

Please write your message below. Note: message must be fewer than 10,000 characters in length: *

Would you like a response? *

Yes

No

I would like to subscribe to the newsletter

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Internship Application

Note: Fields marked with an * are required.

Please complete and submit the form below to apply for an internship in one of our offices.

Your Name

Prefix *

Ms. Miss. Mrs. Mr. Rev. Dr. The Honorable Rabbi

First Name *

MI

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D. and Family

Street Address *

Street Address Continued

City *

State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

+4 Extension

Email *

Your Phone

Phone Number *

Phone Type *

Standard telephone device Videophone [VP] Text-telephone device [TTD]

What are these options?

Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone.

Permanent Address (If different)

Street Address

Street Address Continued

City

State

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code

Emergency Contact

Emergency Contact Name *

Emergency Phone Number *

Phone Type

Standard telephone device Videophone [VP] Text-telephone device [TTD]

Academic Information

Is academic credit available for internships?

Yes

No

Relevant if you are currently enrolled in College/University.

College or University: *

Year in School *

Graduation Date *

GPA *

Major *

Activities/Honors *

Applicable Skills

List specific issues or areas of interest to you *

Have you served a prior internship in Washington D.C. or in a district office? If yes, with whom? *

Additional Information

Desired Location(s) *

District Office Washington DC Office District Office and Washington DC Office House Republican Conference

Desired Session(s) *

Fall Spring Summer Fall, Spring, Summer

Date of Birth

Names and Email Addresses of Three References *

How would you describe your current political philosophy? *

What would you like to gain from this internship? Both professionally and personally. *

Do you have any ties to Michigan’s Ninth Congressional District or any Congressional staff? Please describe. *

Please use this box to write a brief paragraph about yourself, including the reasons why you would like to intern in a congressional office *

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Newsletter Unsubscribe

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If you would like to unsubscribe so that you no longer receive newsletter updates, please enter the email address with which you originally subscribed, below. You may re-subscribe or subscribe with a different email address at any time.

First Name *

Last Name *

Email *

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Request a Meeting

Note: Fields marked with an * are required.

Prefix *

Ms. Miss. Mrs. Mr. Mr. and Mrs. Rev. Dr. The Honorable Rabbi

First Name *

Middle

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D. and Family

Organization *

Title *

Website

Street Address *

Street Address Continued

City *

State *

Zip Code *

Email *

Phone Number *

Phone Type *

Voice Videophone [VP] Text-telephone device [TTD]

What are these options?

This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option “Voice” is a normal audible telephone.

Type of Appearance *

Appearance (Non-Speaking) Meeting Request Speaking Request

Event Location *

In District Washington, DC or elsewhere

Event Date *

Number of Attendees *

Topic of Engagement *

Details *

Human Validation

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Subscribe to Newsletter

Note: Fields marked with an * are required.

Please sign up here to receive email newsletter updates. You may cancel or unsubscribe at any time.

First Name *

Last Name *

Email *

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Tour Request

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Contact Information

Prefix *

Mr. Mrs. Ms. Mr. and Mrs. Miss Dr. Dr. and Mrs. Dr. and Mr. Drs. Professor The Honorable Reverend Pastor Representative The Reverend Monsignor The Reverend Dr. Sister Brother Rabbi Gen LtGen MajGen Brig Gen Col LtCol Maj Capt 1stLt 2ndLt CWO WO SgtMaj MGySgt 1stSgt MSgt,MSgt GySgt SSgt Sgt Cpl LCpl PFC Pvt CMSAF CMSgt SMSgt TSgt SFC SSG SP ADM VADM RADM RDML ENS CDR LCDR LT LTJG SA SN PO3 PO2 PO1 CPO SCPO MCPO Amn A1C SrA

First Name *

MI

Last Name *

Suffix

2nd 3rd 4th II III IV Jr. Sr. M.D. PH.D.

Street Address *

Street Address (2)

City *

State *

AL AK AZ AR CA CO CT DE DC FL GA HI ID IN IL IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code *

Email *

Phone Number *

Phone Type *

Voice Videophone [VP] Text-telephone device [TTD]

What are these options?

This is to help the constituents that are hard of hearing or use a video phone alert us to that fact so we can use the proper technology when we need to call them. The default option “Voice” is a normal audible telephone.

Tour Information

Please select each ticket type you would like me to request for you:
Tickets are free, and provided on a first-come first-served basis. If my office is unable to secure a congressional tour for the sites you selected, most locations are available for public tours. Please visit house.gov for information about public tour information for many of the sites in Washington D.C. 

Admittance is determined by the individual tour site or agency, not by the Congressional office. Unless specified, tours are available Monday through Friday.

White House

Capitol

Trip Information

Date Arriving in D.C *

Date Leaving Washington D.C. *

DC Contact Phone Number *

Total Number of People in Party *

Dates Available for Tours *

Dates Available for White House Tour (Note: Tours are only available Friday and Saturday)

Write us about your tour details and any special accommodations that you may need (please include the first and last names of each member of your party here). *

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Website Problem

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Thank you for taking the time to visit my website. I am constantly working to make my website more useful to you. If you have encountered a problem while using this website or can help me learn how I can improve it to better suit your needs, please let me know. I apologize for any inconvenience.

First Name *

Last Name *

Email *

Web page with the problem *

Please describe the problem *

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