2023 Special PA District Convention Registration

April 1, 2023 at 2 pm


Online Registration Form

  • By submitting and completing this form, I am certifying that I have been chosen by my club or another club to be one of their three voting delegates at the special district convention.
  • District Board Members, Trustees, Lt. Governors and Past Governors may represent any club not otherwise represented by a member. If doing so, they should list the club they are representing in the club block above.
  • Past Lt. Governors can represent any club in their Division which is in good standing.
  • All clubs in good standing may have up to three voting delegates.
Name(Required)
Are you a Delegate at Large?(Required)
This means you are Current/Past Governor, Current/Past Trustee and Current/Past Lt. Governor AND you are representing a club OTHER THAN YOUR OWN. If you are representing your OWN club you are not a Delegate at Large.
If you are representing a club other than your own, that club must be in your Division and MUST be in good standing.
Address

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