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Delegate Registration

• Delegates must be voting financial members of the Association.
• Only one (1) Delegate or Alternate Delegate per membership is allowed.

  1. Refer to Annual Conference Representation Schedule to obtain the number of delegates your District Council is entitled to send to the Annual Conference.
  2. Complete the details in full making sure you include Membership Numbers.  
  3. Please advise Head Office of any changes in the delegates representing your District Council.

There will be an option to submit additional delegates on the confirmation page after you click on the Submit Button.

Submitted by:
Email Address:
District Council:
Region:

DELEGATE INFORMATION
Delegate No 1
Delegate Type:   
Member No:    
Title:    
Surname:  
First Name:    
Preferred Name on Name Tag:   
Gender:  
Age:  
Address:  
Phone:    
Mobile:    
Email:  
Days Attending:
  •  
  •  
 
Delegate No 2
Delegate Type:   
Member No:    
Title:    
Surname:  
First Name:    
Preferred Name on Name Tag:   
Gender:  
Age:  
Address:  
Phone:    
Mobile:    
Email:  
Days Attending:
  •  
  •  
 
Delegate No 3
Delegate Type:   
Member No:    
Title:    
Surname:  
First Name:    
Preferred Name on Name Tag:   
Gender:  
Age:  
Address:  
Phone:    
Mobile:    
Email:  
Days Attending:
  •  
  •  
 
Delegate No 4
Delegate Type:   
Member No:    
Title:    
Surname:  
First Name:    
Preferred Name on Name Tag:   
Gender:  
Age:  
Address:  
Phone:    
Mobile:    
Email:  
Days Attending:
  •  
  •