District Convention 2022 Delegate Form

Each charter club in good standing shall be entitled to three (3) delegates to the convention. These delegates shall be elected not less than thirty (30) days prior to the convention. An alternate should be chosen for each delegate. Each delegate will be entitled to cast one vote and in his/her absence an alternate may cast one vote. There will be no voting by proxy.

Each club delinquent in the payment of International or District obligations shall not be considered in good standing, and therefore not permitted to vote until payment is made.

You will receive an email confirmation when the form is successfully submitted.

THIS IS TO CERTIFY that the following members of this Club are duly elected delegates to the Pacific Northwest District Convention.
Delegate Name
Office
Email or Phone Number
 
(Include the delegate's name, office, and e-mail or telephone number. Click plus button to add another delegate.)
THIS IS TO CERTIFY that the following members of this Club are duly elected alternates to the Pacific Northwest District Convention.
Alternate Name
Office
Email or Phone Number
 
(Include the alternate's name, office, and e-mail or telephone number. Click plus button to add another alternate.)
Our Club has budgeted to help defray the costs for our delegates to attend DCON.
I certify that the club board approved the listed delegates.
I certify that the club board approved the listed delegates.
Drop files here or
Max. file size: 32 MB.
    Please upload the board minutes certifying your delegates if only one officer is signing.
    MM slash DD slash YYYY

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