First name
Last name
Year (20XX)
School (BC, CC, SEAS, JTS, BCDD, GS)
Columbia Uni
Phone
Home State
Zip
Home Congressman (e.g. Mark Kirk)
Have you been on a previous lobby mission with LionPAC or another organization?
Are you involved in any other political groups on campus, such as the college Democrats or Republicans? (Please specify)
Would you be interested in helping us plan this mission?