| First Name |
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| Last Name |
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| College/University |
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| Anticipated Year of Graduation |
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| Email |
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| Cell |
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| Relationship to Roosevelt |
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| Policy Interests |
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| How did you hear about us? |
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Are you interested in presenting a policy idea or proposal at the workshop? |
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| Food Requirements |
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| How do you plan on participating? |
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| Type of participant |
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