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Governor's office

101 N Carson St, Carson City, NV 89701 Nevada State Capitol Building

Form Section 1

Disclaimer: Personal Identification Information (PII) collected from this form will only be used by the Governor’s office to contact the requestor, and technical support of the environment. We will not disclose any of your PII collected from this form and will ensure we follow NRS 603 on PII.


Intern Application 
Completion of this application packet and a successful background check is a requirement for your Internship with the Office of the Governor

 

Biographical Information

Check one or fill in “Other”
Residence Address:
Have you ever been known by any other legal name?
Are you a U.S. Citizen:
If you are a naturalized citizen, date of naturalization:
Date Picker
Are you a Veteran?
Form Section 2

Professional Information

Employer and/or School address
Form Section 3

Educational History – specify school attended, year of graduation and type of degree received

Are you an Undergraduate or Graduate?

References

Background Information

Have you ever had your driver’s license suspended or revoked?
Have you ever been arrested or convicted of a criminal offense or complaint, including traffic offenses?
Have you been the subject of any previous background check due to appointment to a federal, state or local agency or board?
Please Sign