President’s Club Registration Form

President's Club Registration Form

Presidents, please submit one ActBlue payment for all delegates. Attendees are $70 and students are $25 each. The last day for registration is May 1, 2024.

Region

Club

Submitted By

Name and Position

# of Attendees

Number of members attending at $70 each

# of Students

Number of students attending at $25 each

Total

Amount Due

State Officers/Committee Chairs or Proxy (automatic delegates):

Name and Position

State Officers/Committee Chairs or Proxy (automatic delegates):

Club President or President Proxy (automatic delegate):

Elected Delegates (elect 1 for every 5 active and life members; excludes associate and honorary members):

Delegate Alternates (may have 1 for every 5 active and life members; excludes associate and honorary members):

Non-member/Guests:

If you would like a copy of your entries, print a copy or click Print and then save as a PDF BEFORE YOU PUSH SUBMIT.

Finish and Pay
You will be forwarded to the payment page when you click below.