Application

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:

Information Technology Experience

Apple Store
 Microsoft Store 
 Best Buy 
 Hardware Repair 
Computer Consultation 
Audio/Video Setup
 Tablet/Smartphone
 Help Desk 
Other

Specialized Software Skills

Adobe Photoshop
Adobe Illustrator
Adobe Dreamweaver
Adobe Flash
Adobe InDesign
Adobe Premier
Adobe Audition
 HTML
Office (or equivalent)
 Android
 iOS

Other Skills

List Information Technology Classes 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 Internship Program.

Please email or mail transcripts (unofficial copy is acceptable), at least two letters of recommendation, and a resume to:

Jen Carlton, Senate Majority Staff Director
State House, Room 130
200 W. Washington Street
Indianapolis, Indiana 46204
jcarlton@iga.in.gov
317-233-2250