WEA's 81st Delegate Assembly WEA Delegate Form Please complete this form (all information is needed) by February 15, 2013. Please be sure to include street and email addresses for each delegate.If you have any questions contact Cherie Cox at 307-634-7991 ext. 101 Question Title * 1. Name of Local Education Association? Question Title * 2. Name of Local President? Question Title * 3. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 4. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 5. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 6. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 7. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 8. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 9. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 10. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 11. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 12. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 13. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 14. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 15. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 16. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 17. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 18. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 19. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 20. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 21. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 22. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 23. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 24. Delegates Name Delegate or Alternate Email Address Street Address City/Zip Position in the School District Ethnic Minority (Y/N) Question Title * 25. Comments: Done