Delegate Certification

Club Presidents or Secretaries may use the form below to certify delegates to the 104th Ohio District Kiwanis Convention. This form will be active through August 8, 2022, after which delegates must bring a completed paper form with them to the convention for certification.

Delegate Certification

Each club in good standing shall be entitled to representation by no more than three (3) delegates. District Bylaws state that two of these delegates should be your President and President-Elect. An alternate should be chosen for each delegate. There shall be no voting by proxy. Delegates are required to register for the convention. Proof of registration will be required for the issuance of delegate credentials.

"*" indicates required fields

Name*
Delegate #1 Name
Delegate #2 Name
Delegate #3 Name
Alternate #1 Name
Alternate #2 Name
Alternate #3 Name
A Past Lt. Governor for your division may serve as one of your three (3) club delegates at the District Convention. In lieu of a club member serving as a delegate, please use the following space if you wish a Past Lt. Governor to serve as a delegate. Enter their name and the year served as LTG.
Certification*
This field is for validation purposes and should be left unchanged.

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