Intern Request Form, 2019 Legislative Session

(To be filled out by Legislator)

Thank you for your interest in the Legislative Internship Program. Our ongoing goal is that participation be mutually beneficial for both the student and legislator they are assigned to. Your engagement is essential to positive outcomes in that regard. Therefore, before requesting an intern, please make sure you can:

  • act as a mentor to your intern throughout the legislative session, including weekly communication (in person or over the phone) between you and that student;
  • commit to the timely completion of two formal meetings between you and your intern, related to their grading and evaluation. The first is within the first two weeks of the internship, in order to discuss goals and expectations, and the second is in early March to complete a mid-term evaluation;
  • agree to support their educational experience, advise in their individual goal setting, and promote their interest/involvement in other areas of state government as well. We provide a full programming series and individual counseling to assist in this regard;
  • discuss this commitment with your staff and they are prepared, in your absence, to be a resource for your intern to rely on for support.

See our 2019 Policy Guide, for all program procedures including excused time/attendance, student/legislator evaluation, as well as our new Social Media Policy.

Please contact our Program Director, Lisa Roy, with any questions you may have regarding program procedure at:, (860) 240-0520, or Monday-Thursday in Room 5150.

Thank you!

Request Deadline: Monday, November 26, 2018

*Please do not list your LA. This should be a number where you, the legislator, can be contacted by the program. This number will not be listed or distributed.

I would like to request a: (please check one) 
Part-Time Requests Only. I would prefer to have an Intern: (please check one) 

An internship is a mutually beneficial partnership involving the student, legislator, and legislative staff. By requesting an intern, and signing below, I agree to the following (all boxes must be checked for request to be processed):

   I will make myself available to mentor my intern throughout the legislative session.
   I am aware that I must meet with my intern within the first two weeks of the internship in order to discuss and document goals and       expectations, and again in early March for a mid-term evaluation.

   My staff is aware that I am requesting an intern and, in my absence, will be a resource for my intern to rely on for support.
   I have been provided with the Legislative Internship Program Policy & Procedure Guide and have familiarized myself with the contents.
   I understand that attendance requirements must be followed and my responsibilities there-of.

Note: A typed name will substitute for a handwritten signature

HARTFORD, CT 06106-1591

Phone: (860) 240-0520
Fax: (860) 240-0122