Name of Delegate Agency________________________________________Address______________________________________Telephone_____________ Site Name (Where Appropriate) __________________________________ Address _____________________________________Telephone _____________ Type of Election (MUST Check One) Delegate Agency Site Parent Committee Delegate Agency Policy Committee/Council Date______________________ COPIES OF PROXY LETTERS Number of Representatives Present: _________ *Number of Proxy Nomination Letters: ________*ATTACH Motion Seconded Motion Number Number of of Reps to Close By Passed Office Nominee Nominated By Declined Votes Present Nominations Yes No Chairperson Vice Chairperson
Name of Delegate Agency________________________________________Address______________________________________Telephone_____________ Site Name (Where Appropriate) __________________________________ Address _____________________________________Telephone _____________ Type of Election (MUST Check One) Delegate Agency Site Parent Committee Delegate Agency Policy Committee/Council Date______________________ Number of Representatives Present: _________ *Number of Proxy Nomination Letters: ________*ATTACH COPIES OF PROXY LETTERS Office Nominee Nominated By Declined Motion to Close Nominations Seconded By Motion Passed Number of Votes Number of Reps Present Yes No Chairperson Vice Chairperson