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DELEGATE CERTIFICATION FORM 2009 Arkansas Federation Of Republican Women, 27th Biennial Convention Maumelle Country Club, Maumelle AR April 4, 2009 NAME OF CLUB_______________________________________________________________________ 1. Name ______________________________________________________________________________________ Delegate ____Alternate ____ Club President _____ AFRW Board of Directors ________ 2. Name ______________________________________________________________________________________ Delegate____ Alternate ____ Club President _____ AFRW Board of Directors ________ 3. Name ______________________________________________________________________________________ Delegate____ Alternate _____ Club President _____ AFRW Board of Directors _______ 4. Name _____________________________________________________________________________________ Delegate _____ Alternate _____ Club President _____ AFRW Board of Directors ______ 5. Name _____________________________________________________________________________________ Delegate _____ Alternate _____ Club President _____ AFRW Board of Directors ______ The voting body shall be: 1) Members of the Board of Directors (including the club president), 2) two delegates elected from each club, 3) plus one additional delegate elected for each fifteen (15) members. For each elected delegate, the club is entitled to one alternate. Membership for delegates/alternates is based on per capita dues paid on membership on December 31, 2008. Article 7- Dues Section 4 of AFR Bylaws states: Only clubs whose dues are paid thirty (30) days prior to the Biennial Convention shall be entitled to representation in the convention. The delegates shall be selected in such a manner as their respective clubs shall prescribe; the selection shall be made not less than two (2) weeks prior to the convention, or not later than March 21st THIS SECTION TO BE COMPLETED BY THE CLUB PRESIDENT I hereby certify that the above named individuals are members in good standing of my club and are qualified to represent this club as delegates/alternates at the AFRW 27th Biennial Convention on April 4, 2009. Club President Name ___________________________________Signature __________________________________ Club President Address________________________________________________________________________________________ Club President Phone(s) _____________________________________________ Email___________________________ Send signed and completed form to: Jonelle Fulmer, 5209 Rosewood Circle, Fort Smith, AR 72903-0775email: jdsjonelle@aol.com THIS FORM MUST BE POSTMARKED NO LATER THAN MARCH 21, 2009 FORM MAY BE COPIED. IF MORE THAN ONE FORM IS NEEDED FOR LARGER CLUBS ENTITLED TO MORE THAN FIVE (5) DELEGATES, PLEASE SIGN ALL FORMS SUBMITTED.
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