This form will collect the names of the Delegates and Alternates who have been elected to represent your Club at the International Convention of Altrusa International, Inc. in Quebec City, Quebec July 23-26, 2025. Please provide the name of your Club, which District you belong to, and your name as well as your title within the club.

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* 1. Altrusa International of

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* 2. District

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* 3. Name and title of submitter:

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