If you have any questions, comments, or concerns, please feel free to contact the office of California State Senator Joel Anderson at (619) 596-3136. Contact Information Desired Internship Location * El Cajon Sacramento San Marcos Name * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003 Street Address * City, State, Zip * Phone Number * E-Mail Address * Parent/Guardian Contact Information (if minor) Name Street Address City, State, Zip Phone Number Education Name of School * Current Grade * Freshman Sophomore Junior Senior Graduate Major (if applicable) Availability Days (can select multiple days) * Sunday Monday Tuesday Wednesday Thursday Friday Saturday Hours Please note if there are only specific hours you are available on the days selected above: Hours Desired Per Week Additional Information (office) Will you receive credit for this internship? * Yes No Do you have reliable transportation? * Yes No If Yes, would you be willing to drive to district events? * Yes No Have you read How to Win Friends and Influence People? * Yes No Where do you get your daily news? (3 sources) * How did you learn about this internship? (name of person if applicable) * Additional Information (personal) Skills * Interests * Awards/Honors * Extracurricular Activities * Resume * Please attach your resume as a PDF or Word Document. References Reference 1 Please include: Name, Occupation, Address, and Phone Number Reference 2 Please include: Name, Occupation, Address, and Phone Number Certification Statement I Certify That The Information Contained In This Application Is True And Complete To The Best Of My Knowledge. I Understand That Any False Statement Is Grounds For Immediate Dismissal From This Legislative Internship Program.