2013 Indiana House Page Program

House Page Application

If you are interested in serving as a legislative page at the Indiana House of Representatives, please complete this application. Your application will be forwarded to the House Page Office and you will be contacted with further information.

Questions marked with a * are required.

We ask that page applicants identify two different dates when they can come to the Statehouse between the first week of January through April. In choosing these two dates, please note that Mondays, Tuesdays and Thursdays are generally the best days to serve (no pages are scheduled for Fridays). Because of space restrictions in the program, you may not get your first choice for a date in serving as a page.
*1. Preferred date to page | 1st choice (mm.dd.2013):
*2. Preferred date to page | 2nd choice (mm.dd.2013):
3. Representative's name:
*4. Page's first name:
*5. Page's last name:
*6. Address:
*7. City:
*8. ZIP:
*9. Age:
*10. Email address:
*11. Home telephone number:
12. Parent / Guardian's name:
*13. School:
14. Please note any special arrangements that may be required:
*15. Today's date (mm.dd.2013):
When this application has been completed, please click on the "Submit Survey" button below. Several fields are required and if you have failed to complete any of them, the survey will reappear. If you receive a "thank you" message screen, your application has been successfully submitted.