2024 Delegate and Alternative Delegate Registration Form  
Note: All Delegates and Alternate Delegates must be financially active to represent a chapter. Additionally, the Chapter must be in good standing to include all Financial Assessments having been met in full. Any chapter not meeting the above requirements will be refused representation for the duration of the conference procedures and deemed ineligible to vote. Deadline: April 1, 2024
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Primary Delegate Name (Last Name, First Name)
 *
Primary Delegate Phone Number *
Primary Delegate Chapter Name (Spell Out)
 *
Primary Delegate State
 *
Primary Delegate Membership Number
 *
Primary Delegate Chapter President (Last Name, First Name)
 *
Alternative Delegate Name (Last Name, First Name)
Alternative Delegate Membership Number 
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