1

APPLICANT INFORMATION

Student Name (*) Invalid InputGrade89101112 Invalid Input

Mailing Address (*) Invalid Input

City (*) Invalid InputState (*) Invalid Input

Zip (*) Invalid Input

Email (*) Invalid InputHome Phone Invalid Input

School Invalid InputSchool District Invalid Input

Have you participated in a previous CAGT Legislative Day? YesNo Invalid Input

2

REQUIRED INFORMATION

State Senate District No. (*) Invalid Input State House District No (*) Invalid Input

(See www.congress.org for locating your state legislators)

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LEGISLATOR PREFERENCE

Do you have a preference for a legislator to shadow? YesNo Invalid Input

If yes, who is your preference? Invalid Input

4

WRITTEN RESPONSE

Please respond to the following question in approximately 300 words. Priority will be given to applicants who provide typed, well-written, thoughtful responses. Please prepare your response in a word processing document and then cut and paste it into the box

What particular state legislative issue would you like to discuss with your assigned legislator?
Explain why it is important to you.