APPLICATION TO request A KAREN SHEPHERD INTERN

(To be filled out by candidate)

Candidate Name
Office Running For (Include District)
Campaign Address
City
State
ZIP
Telephone
Fax
E-Mail

I will publicly, or have already voted in support of bills which advance political ethics by strengthening the law with regard to campaign finance reform, lobbyist disclosure and gift-ban legislation.

check the box to affirm the above statement.

HOW WILL YOU INVOLVE AN INTERN IN YOUR CAMPAIGN?
(Please be specific. Interns will review this information to choose their internships.)