Intern Application

March 16, 2012
Office of New York State Assemblywoman Sandy Galef
2 Church Street, Ossining, NY 10562
(914) 941-1111, (914) 941-9132 (fax)
First: *
Last: *
Email: *
Address: *
Apt #:
City: *
State: *
Zip: *
Phone: *
* Indicates Required Field

Name of School (fall attendance)
Grade Level (fall)
Major (if applicable)
Coursework in Government
Other Experiences in Government (internships, student government)
Volunteer Positions Held (please give dates)
Special Spoken and Written Communication Skills
Experience/Knowledge of Computers and Word Processing Programs
Availability (Times/days of the week/start and stop date if applicable)
Additional Pertinent Information
Why are you interested in working for a state government office?
Please write a short paragraph on what you expect or would like to gain from your internship: