Internship Application - Senator Picozzi

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Name*

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Email*

Phone*

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Are you a registered voter?*

Yes

What state are you registered to vote?*

Are you a U.S. Citizen?*

Yes

Permanent Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Temporary School Address (if applicable)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

School Attending*

Graduation Date*

Campus Involvement*

300-500 words on why you would like to intern*

Please paste a plain text version of your resume here*