The National Executive Committee, in Resolution No. 32 adopted October 14-15, 1992, has requested background information on all Legionnaires nominated for the National Legislative Council. This information is submitted to the National Commander for review prior to appointment to the National Legislative Council.

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Full Name: *

Address: *

City: *

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Home Phone:

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E-mail: *

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Congressional Member that you will serve as liaison to:

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Brief summary describing your relationship with this Member of Congress: