Personal Information:
Last Name:
First Name:
MU Student ID:
Phone #:
Email:
Level:
Freshman
Sophomore
Junior
Senior
Grad Student
Other
Major:
Current Address:
Street:
City:
State:
Zip Code:
Dorm andRoom # or Apt #
Are you registered to vote?
Yes
No
If so, where?
Activities:
(Any that apply)
Fraternity:
Student Govt:
Sorority:
Service Orgs:
Other:
Other:
We're glad you decided to sign up to be a member of the College Republicans. With this information, we can better inform you of events and meetings. Don't forget, membership dues are $5 for the year - pay at our meeting.
Thank You!
To be removed from our listserve email
jlt45f@mizzou.edu
with "College Republicans" in the subject line.
