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* 1. Name

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* 2. Email Address

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* 3. School

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* 4. Age

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* 5. Which cohort would you like to apply to?

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* 6. Gender

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* 7. Political Leaning

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* 8. What congressional district do you currently reside in?

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* 9. What are your hobbies?

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* 10. What are your policy interests?

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* 11. What does bipartisanship mean to you?

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* 12. Would you be interested in being featured in the Civic Synergy blog or social media?

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* 13. How did you hear about us?

Thank you so much for applying! We will be in touch shortly to discuss application status and next steps.
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