LIST REFERENCES LEGISLATORS WORK TRAINING AND/OR WHO KNOW ABOUT YOUR AND/OR Name Address Phone Number ( - ) ( - ) ( - ) PLEASE DESCRIBE INTEREST WORKING LEGISLATURE YOUR IN FOR THE CHAMBER PREFERENCE Senate No Preference IN WHICH CAPACITY INTERESTED SERVING 65TH LEGISLATIVE SESSION ARE YOU MOST IN THE Non Partisan Support Republican Office Democrat Office PLEASE SPECIFY DESIRED POSITIONS LEGISLATIVE EXPERIENCE (YEAR POSITION) AND ADDITIONAL SKILLS AND/OR INFORMATION THAT COULD HELP YOU QUALIFY FOR THIS POSITION With my signature below (typed or written), I certify that all information on this and all attached pages is true, correct and complete to the best of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to release job-related information they may have about me and I release all persons or companies from any liability or responsibility for providing such information. Signature: Date:
LIST REFERENCES AND/OR LEGISLATORS WHO KNOW ABOUT YOUR WORK AND/OR TRAINING Name Address Phone Number ( ) - ( ) - ( ) - PLEASE DESCRIBE YOUR INTEREST IN WORKING FOR THE LEGISLATURE CHAMBER PREFERENCE Senate No Preference IN WHICH CAPACITY ARE YOU MOST INTERESTED IN SERVING THE 65TH LEGISLATIVE SESSION Non Partisan Support Republican Office Democrat Office PLEASE SPECIFY DESIRED POSITIONS LEGISLATIVE EXPERIENCE (YEAR AND POSITION) ADDITIONAL SKILLS AND/OR INFORMATION THAT COULD HELP YOU QUALIFY FOR THIS POSITION With my signature below (typed or written), I certify that all information on this and all attached pages is true, correct and complete to the best of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to release job-related information they may have about me and I release all persons or companies from any liability or responsibility for providing such information. Signature: Date:
SessionApplication2017.docx