House Page Application

Applicant Information

First Name *

Last Name *

Preferred First Name *

DOB *

Address *

City *

State *

Zip Code *

County *

Country

Student Email *

Cell Phone *

Home Phone

Name as it should appear on Nametag *

Name as it should appear on Certificate

Gender:

Are you related to a Member of the North Carolina Legislature?

Yes

* Please state member's name and relationship to you:

Applicant Eligibility

GPA

Current School

2023-24 Grade Level *

Currently, are you in good academic standing?

If serving during the academic year, did you obtain prior approval from your school?

Have you ever served as a House Page?

Yes

What year did you serve as a House Page?

Have you ever served as a Senate Page?

Yes

What year did you serve as a Senate Page?

Essay Requirement

In addition to the application, program applicants are required to submit a short essay. Students should draft an essay that describes their interest in, and reasons for, applying to the House Page Program. Specifically, the essay should answer the question, "Why do you wish to participate in the 2024 House Page Program?" It should be limited to 200 words, while thoroughly addressing the question.

Photo Requirement

Each applicant must provide a current color photo for the application to be considered complete. The photo should be appropriate for use for security and in an emergency. Images must be .jpg, .png, .gif, or .bmp formats and below 175 MB.

Please note that House Pages attend daily sessions of the North Carolina House of Representatives and committee meetings, all of which are livestreamed, recorded, posted on the North Carolina General Assembly webpage, and available for public viewing. While your child is serving as a House Page, others, including Members of the House of Representatives or the public may photograph your child. You and your child should discuss how to handle instances in which someone asks to take a photograph with your child while serving as a House Page.

Parent/Guardian Information

Parent/Guardian Name *

Cell Phone *

Occupation

Work Phone

Parent/Guardian Email *

Parent/Guardian Name

Cell Phone

Occupation

Work Phone

Parent/Guardian Email

Emergency Contact Name *

Phone *

Parent/Guardian Consent *

You are the parent/guardian of the House Page Applicant.

Consent and permission for him or her to participate in the North Carolina House Page Program.

All of the information provided above has been reviewed with the applicant.

Acknowledgement and agreement to the rules and guidelines set forth by the House Page Program.

Applicant Acknowledgement

Please carefully review the following information.

Program participants are expected to participate in all scheduled events and activities.
Participants are not permitted to leave any of the program activities without explicit authorization of the program advisor.
Program participants are expected to adhere to a professional dress code. Any House Page that does not comply with the dress code will be asked to correct their attire and may be barred from participation or sent home.
Program participants are responsible for all personal costs associated with participation in the program.
Program participants have the option to be paid a stipend or receive community service credit. Pages that opt for a stipend will be paid a total of $150.00 for one week of service. Pages who opt to receive community service will be credited 30 hours in accordance with that Page's school policy.
If the legislature adjourns prior to the completion of the program, the remaining appointments will be cancelled and affected program participants will be notified.

By signing below, I am acknowledging that I've read the information provided above and meet the age requirements to be eligible to participate in the House Page Program. I attest that the information provided above is true and accurate to the best of my knowledge. *

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