Application

Speciality:
Press Secretary Policy Analyst Multimedia

Name:

College/University:

Grade Level:
Senior Junior Sophomore Graduate Graduate Student

Major:

Minor:

Expected Graduation Date:

Grade Point Average:

Campus Address:

Permanent Address:

Telephone: (Current)

Telephone: (Cell)

Political Affiliation:
Republican Democrat Other

Email Address:

College Activities, Honors and Awards:

Communications Experience

College Newspaper
Commercial Newspaper
College Magazine
Commercial Magazine
College TV News
Commercial TV News
College Radio
Commercial Radio
Kappa Tau Alpha
PRSSA
Radio & Television News Directors Association
SPJ
NPPA
Other

Specialized Communications Skills

Adobe Photoshop
Adobe Illustrator
Adobe Dreamweaver
Adobe Flash
Adobe In-Design
Quark XPress
Cool Edit Pro
Avid Media Composer
Facebook
Twitter
Digital Photography

Other

List Communications Classes (journalism, public relations, telecommunications, speech or English) you have successfully completed or are currently enrolled:

Professional References

Current Employer:

Position:

Responsibilities:

Immediate Supervisor: 

Telephone:

Beginning Date / Ending Date:

Previous Employer:

Position:

Responsibilities:

Immediate Supervisor:

Telephone:

Beginning Date / Ending Date:

Academic References

Name:

Address:

City/State/Zip:

Title:

Telephone:

Name:

Address:

City/State/Zip:

Title:

Telephone:

I certify that there are no misrepresentations or falsifications of these statements and answers. I am also aware that falsification of this application, or any accompanying data, may result in my dismissal from the Senate Intership Program.

Please email or mail transcripts, best work samples and resume to:

Amy Surber, Senate Majority Internship Director
State House, Room 126
200 W. Washington Street
Indianapolis, Indiana 46204
asurber@iga.in.gov
317-232-9984