U.S.

Senate Page Program Application

Office of Senator Lisa Murkowski
709 Hart Senate Office Building
Washington, D.C. 20510
Phone: (202) 224-6665
Fax: (202) 224-5301
FULL NAME: ________________________________________________________________
Last
First
Middle
FULL LEGAL ADDRESS IN ALASKA:
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EMAIL ADDRESS: ____________________________________________________________
PHONE: ________________________ DATE OF BIRTH: ____________________________
MALE OR FEMALE (circle one)
NAME OF HIGH SCHOOL: ____________________________________________________
CURRENT YEAR IN HIGH SCHOOL: ____________________ CURRENT GPA: ______
PLEASE LIST AND EXPLAIN ALL EXTRA CURRICULAR ACTIVITIES:
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ARE YOU CURRENTLY EMPLOYED? YES/NO (circle one)
IF SO, WHERE: ________________________________________________________________
HOURS PER WEEK: DURING SCHOOL YEAR: ____________ SUMMER: _____________
PLEASE ATTACH A LETTER OF RECOMMENDATION FROM SOMEONE WHO
KNOWS YOU WELL, SUCH AS A TEACHER, CLERGY OR COMMUNITY
MEMBER.

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IN THE SPACE PROVIDED BELOW PLEASE EXPLAIN YOUR INTEREST IN THE

U.S. SENATE PAGE PROGRAM:
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SIGNATURE

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DATE

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