Page Day Application Favorite Registration Information IEC Page Day is open to all Indiana high school students. Space is limited and filled on a first-come, first-served basis.To be considered, please complete the registration form below. You’ll receive a confirmation email once your submission is received. The deadline to apply for Page Day is January 9, 2026. GENERAL Information Page Day will take place at the Indiana Statehouse in Indianapolis, on January 27, 2026. Highlights include a Statehouse tour, mock bill activity, and the opportunity to see the Indiana Legislature in action. Please note that students must arrange their own transportation to and from Indianapolis in order to participate. Parking information will be provided. Please contact Karlee Gable at KGable@IndianaEC.org for additional information. Student Information First Name * Last Name * Preferred Name Enter your name exactly as you would like it to appear on your name badge. Student Email * Please use a personal email address, rather than a school email. Mobile * High School * Grade * Select from the dropdownFreshmanSophomoreJuniorSenior Home Address * Home Address Home Address Home Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Please upload a current headshot of the student. Drop a file here or click to upload Choose File Maximum file size: 209.72MB If you have issues uploading your headshot, please email your photo to KGable@IndianaEC.org upon completion of your application. Other Information Have you attended a previous Page Day with Indiana Electric Cooperatives? * Yes No This does NOT affect your eligibility! Students are welcome to attend Page Day more than once. Find your state legislators Please use Find Your Legislator to complete the fields below. Accuracy is important, so even if you think you know your state legislators, take a moment to verify using the link. Name of State Senator * Senate District # * Name of State Representative * House District # * Cooperative Information IEC Page Day is held in partnership with Indiana’s electric cooperatives. While you do not need to be a member to attend, we ask that you confirm whether your home receives service from an Indiana electric cooperative. Visit Who Is My Service Provider to verify using your home address, then select your electric cooperative below. If you do not receive service from one of the 37 Indiana electric cooperatives listed below, please select “Not a member or unsure". Please remember this does not affect your eligibility to attend Page Day. Cooperative * Select from dropdownNot a member or unsureBartholomew County REMCBoone PowerCarroll White REMCClark County REMCDaviess-Martin County REMCDecatur County REMCDubois REC, Inc. Fulton County REMCHarrison REMCHeartland REMCHendricks Power Cooperative Henry County REMCHoosier EnergyIndiana Electric CooperativesJackson County REMCJasper County REMCJay County REMCJCREMCKankakee Valley REMCKosciusko REMCLaGrange County REMCMarshall County REMCMiami-Cass REMCNewton County REMCNineStar ConnectNoble REMCOrange County REMCParke County REMCPaulding PutnamRushShelby EnergySouth Central Indiana REMCSoutheastern Indiana REMCSouthern Indiana PowerSteuben County REMCTipmont REMCUtilities District of Western Indiana REMCWabash Valley PowerWarren County REMCWhitewater Valley REMCWIN Energy REMC This does NOT affect your eligibility to attend Page Day. In 1–2 sentences, describe your motivation to participate in Page Day and what you hope to learn or take away from the experience. * Visual Code Parent / Guardian Information Guardian First Name * Guardian Last Name * Relationship to Student * Select from dropdownMotherFatherGrandmotherGrandfatherLegal GuardianOther Relationship to Student Email Address * Mobile * plus1 Add minus1 Remove Emergency Contact Information Please provide the name and contact information of another adult (not the parent/guardian listed above). First Name * Last Name * Relationship to Student * Select oneStepmother / StepfatherGrandparentAunt / UncleSiblingFamily FriendOther RelativeOther Relationship to Student Mobile * Work Phone (Optional) Medical Information Please list any medical conditions or health information we should be aware of such as insulin-dependent diabetes, heart conditions, asthma, seizure disorders, mental health conditions, autism spectrum, or food allergies. * If you don’t have any, please type “none.” If you are human, leave this field blank.
