Delegates should be elected and registered by June 8, 2018

Only dues-paid members of clubs in good standing (having paid for at least 15/10 members), as verified by the Circle K club, are eligible to be convention delegates. If a club member is not able to represent the club, the club may vote to have the current or immediate past lieutenant governor for the division or any other current district officer represent the club's voice to the House of Delegates. Certification of representation by a district officer should be demonstrated below. This is to certify that the following individuals are duly elected delegates and alternates to represent the club indicated in this form.

* 1. I am registering