Great Lakes Legislative Caucus (GLLC) Member Enrollment Form
Please use this form to enroll as a member of the Great Lakes Legislative Caucus. Required fields are marked with an asterisk. If you have any questions about the Caucus or enrollment, contact Lisa Janairo at 920.458.5910 or gllc@csg.org.
Member Information
What jurisdiction do you represent?
Name
Your answer
Title
Your answer
Legislative Chamber
Your answer
Legislative Phone Number
Your answer
Legislative Email Address
Your answer
Legislative Mailing Address
Your answer
Personal Email Address
Your answer
Home Mailing Address
Your answer
Staff Information
Staff Name
Your answer
Staff Phone
Your answer
Staff Email
Your answer
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