2. Deadline to turn in application is 4:30 p.m. on Monday, March 27 , 2023
4. Last Name*
5. First Name*
6. Middle Initial
8. Street Address*
9. Apt #
11. State*
12. City*
13. Zip*
15. Date of Birth*
    Date of Birth
17. CELL Phone Number
19. HOME Phone Number
21. EMAIL Address*

    (We communicate via email)

23. SCHOOL Attending
24. GRADE Level
26. Your Commission District:
28. Professional Area of Interest
    (example legal/nursing)
30. BACKGROUND CHECK MUST BE COMPLETED IF YOU ARE 18 YEARS OLD. Applications will NOT be processed without ID and background check form attached. If you are selected, and you do not attend Orientation, you will not be able to work.
32. Brief Essay of your past accomplishments and future goals
    (150 words or less)
34. Sample Authorization form for Background Check
35. Authorization form for Background Check
37. Upload Signed Background Check Authorization Form
Leave This Blank:


39. Submit Submit and Print

* indicates a required field