Election Certification

Division Election Form

The following Kiwanian was elected as Lt. Governor for the division and year indicated below:

Year Serving(Required)

From the drop down menu choose the Kiwanis year the elected Lt. Governor will serve.

Division Name(Required)

Date Elected(Required)

Club Name(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Did you also elect a Lt. Governor-Elect?(Required)

Yes

The following Kiwanian was elected as Lt. Governor-elect for the Division and year indicated below:

Year Serving(Required)

From the drop down menu choose the Kiwanis year the elected Lt. Governor will serve.

Division Name(Required)

Date Elected(Required)

Club Name(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

I certify the election for the Lt. Governor and/or Lt. Governor-elect as submitted.

Name(Required)

First Last

Email(Required)

Comments

This field is for validation purposes and should be left unchanged.