RALLY   DELEGATE   REGISTRATION   FORM

To: Office of the Secretary

      Association of Civilian Technicians

      12620 Lake Ridge Drive

      Lake Ridge, Virginia 22192

Mr. Secretary,

I the undersigned Chapter President OR Chapter Secretary certify the following information is correct by selecting the submit button at bottom of page.

 Chapter President OR Chapter Secretary please provide the following information.

Chapter Name & Number:
Total Number of Chapter Members:
Number of Votes Authorized: See below chart for # of Votes
From the Delegate's listed below, List here which Delegate will be designated to vote for the Chapter.
#1 Delegate First & Last Name:
#2 Delegate First & Last Name:
#3 Delegate First & Last Name:
#4 Delegate First & Last Name:
#5 Delegate First & Last Name:
#6 Delegate First & Last Name:
#7 Delegate First & Last Name:
#8 Delegate First & Last Name:
Provide date of last election for each Listed Delegate. Information necessary in order to properly certify at Rally.
	Enter the text shown in the image above.

 Votes are proportioned as to the number of members each Chapter has on record at the time of this report (see below chart). The Chapter may have one or more voting Delegate's and must be desingated on this form prior to being authorized to vote at Rally Annual Business Meeting. Proxy votes are not authorized.

Members                              # of Votes Authorized

1 -75                                                     1

76 - 125                                                 2

126 - 175                                               3

176 - 225                                               4

226 - 275                                               5

@Copyright 2014 Association of Civilian Technicians. This information may not be republished without express consent.