Application for Internship in the Office of the Governor

This application is intended for persons seeking to serve the Commonwealth in an internship position within the Office of the Governor. Please complete all parts of the application (those marked with an asterisk are required fields). Once finished, please save a copy to your PC and then email the completed application along with a cover letter and resume to the Office of the Governor at [email protected].

Contact and Personal Information First Name:* Middle Initial: Last Name:* Suffix: Date of Birth:* Street Address (Line 1):* Street Address (Line 2): Hometown: City:* State:* Zip Code:* Email Address:* Phone Number:* ( ) Skills Applicable to Internship List specific issues and areas of interest to you:

Academic Information If you are currently enrolled in school, please answer the following: Please list the schools attended, beginning with your current school.

Is academic credit available for internships? Yes / No Advisor’s Name: Year in School: Expected Graduation Date: GPA: What is your major?

Please list any activities you are involved in and/or honors you have received.

Please describe your career objectives.

References Please list three references: 1* Name: Phone Number: ( ) 2* Name: Phone Number: ( ) 3* Name: Phone Number: ( ) Tell us about yourself Please use this box to write a brief paragraph about yourself, including the reasons why you would like to intern in the Office of the Governor. If you prefer, you may include this in your cover letter or a separate document.

THE COMMONWEALTH OF KENTUCKY DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, SEX, AGE, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, GENETIC INFORMATION OR VETERAN STATUS. REASONABLE ACCOMMODATIONS ARE PROVIDED UPON REQUEST.

PC/DHRA April 2016