BVA 78th National Convention Credentials Form – Blinded Veterans Association

This is the official Credentials Form for the 78th National Convention of the Blinded Veterans Association. One copy must be received by National Headquarters no later than July 25, 2023. One copy should be given to the elected delegate and one copy should be placed in the regional group files.

Name of Regional Group *

Name of Elected Delegate *

Name of Alternate Delegate #1 *

Name of Alternate Delegate #2 *

Name of Alternate Delegate #3 *

Name of Alternate Delegate #4 *

Name of Alternate Delegate #5 *

The Delegate and Alternate Delegates were elected at a meeting of the regional group held:

Meeting Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Meeting Date *//

Signatures

Signature of Regional Group President *

Type your name.

Signature of Regional Group Secretary *

Type your name.

Instructions to Delegate, if any:

Name of Bylaws and Resolutions Committee Member *