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    Senate Page Application - Regular Session 2020

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    mortensenk
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    © All Rights Reserved
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    Senate Page Application - Regular Session 2020

    Uploaded by

    mortensenk
    521 views1 page
    application

    Original Title

    Senate Page Application - Regular Session 2020 (1)

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    application

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    521 views1 page

    Senate Page Application - Regular Session 2020

    Uploaded by

    mortensenk
    application

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    The Florida Senate

    SENATOR BILL GALVANO


    President

    2020 REGULAR SESSION - SENATE PAGE PROGRAM APPLICATION

    Name: ________________________________________________________________ Application Deadline is:


    October 1, 2019
    Address: ____________________________________________________ Questions? Contact Senate Administration
    850.487.5636
    City: ______________________________ State: _____ Zip: __________ [email protected]
    Fax: 850.410.0065
    Telephone: ___________________ Date of Birth: ______________________________
    Please note:
    Applicant’s Email: _____________________________________________________
    Pages are required to have a dark navy blue
    blazer. Senate patches will be mailed in
    Parent/Guardian Name: ________________________________________ advance and must be affixed to the blazer.

    Parent/Guardian Email: ____________________________________________________________________


    Emergency Contact Name (if different from above): _____________________________ Telephone: ________________
    Name of High School: ________________________________________________________ Current Grade: ______________

    Have you served previously as a Page? No Yes


    If yes, where (Senate/House) and the year: _________________________________
    Please identify any relatives employed with the Florida Legislature:
    _________________________________________________________________________________________
    Identify any extra-curricular activities which support your interest in the Senate Page Program, include any
    leadership roles held (i.e., debate team, student government, etc.).
    _________________________________________________________________________________________

    Identify in priority order (#1 being your top choice) the week(s) you are available to serve as a Senate Page.
    Week 1: January 14 - 17 Week 4: February 3 - 7 Week 7: February 24 - 28
    Week 2: January 20 - 24 Week 5: February 10 - 14 Week 8: March 2 - 6
    Week 3: January 27 - 31 Week 6: February 17- 21 Week 9: March 9 – 13
    Check here if you have no preference and can be flexible to serve during ANY of the above weeks
    *Requested priorities are not guaranteed
    Please select your preference: Community Service Hours (40) Stipend/payment ($250)
    If known, identify your sponsoring Senator and District: __________________________________________
    If I am selected, I hereby consent to providing my service to the Florida Senate as a Page. I understand the
    Senate does not provide food, housing or transportation, and supervision of Pages does not extend beyond the
    hours I will serve in the Senate (official Senate business).

    Signature of Page Applicant: ________________________________________________________________


    Signature of Parent/Guardian: _______________________________________________________________
    School Principal/designee acknowledges the above program may occur during regularly scheduled school days
    resulting in multiple absences for the student:

    _______________________________________ _______________________________________
    Name (print) Signature

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