Intern Application August 22, 2019 Office of New York State Assemblywoman Sandy Galef2 Church Street, Ossining, NY 10562(914) 941-1111, (914) 941-9132 (fax) Share: Javascript must be enabled to properly view this page. * Indicates Required Field Title First Name * Middle Initial Last Name * Suffix Phone Number * Mobile Number Email * Address (Street Address, P.O. Box, Company Name, c/o)* Street Address, P.O. Box, Company Name, c/o Address Line 2 (Street Address, P.O. Box, Company Name, c/o) Suite, Unit, Building, Floor, etc. Apt Number City * State * Zip * 1. Name of School (fall attendance) * 2. Grade Level (fall) * 3. Major (if applicable) 4. Coursework in Government 5. Other Experiences in Government (internships, student government) 6. Volunteer Positions Held (please give dates) 7. Special Spoken and Written Communication Skills 8. Experience/Knowledge of Computers and Word Processing Programs 9. Availability (Times/Days of the Week) * 10. Additional Pertinent Information 11. Why are you interested in working for a state government office? 12. Please write a short paragraph on another sheet or the back of this page on what you expect or would like to gain from your internship: