NATIONAL BLACK LAW STUDENTS ASSOCIATION 46th Annual Convention Delegate Form This form is for chapters sending its official voting representative to plenary To help facilitate the processing and verification process, this should be sent to the Director of Membership at membership@nblsa.org by February 28, 2014. CHAPTER CHAPTER’S NBLSA EMAIL ADDRESS CHAPTER PRESIDENT CHAPTER PRESIDENT’S EMAIL ADDRESS CHAPTER PRESIDENT’S PHONE NUMBER
For the 2014 Annual Convention of the National Black Law Students Association, I hereby designate the following person as the delegate for _______________ Chapter. NAME OF DELEGATE: ____________________________________________________________ DELEGATE’S EMAIL ADDRESS: DELEGATE’S HOLDER’S PHONE NUMBER:
I hereby certify that I am the duly elected President/authorized representative of the _____________________chapter: _____________________________________
SIGNATURE OF CHAPTER PRESIDENT PLEASE SUBMIT TO MEMBERSHIP@NBLSA.ORG BY February 28, 2014.
NATIONAL BLACK LAW STUDENTS ASSOCIATION 46th Annual Convention Voting Rights Assignment This form is for the assignment of voting rights to a qualified proxy on behalf of a chapter. If a chapter is not sending its official voting representative to plenary, then the voting rights of that chapter may be assigned to another authorized chapter attending plenary in person. That person must be a financially active member of NBLSA and certified by the NBLSA Director of Membership. To help facilitate the processing and verification process, this form along with the Certification for Recognized Proxy Holder form should be sent to the Director of Membership at membership@nblsa.org by February 28, 2014. After this date, forms should be submitted in person. Anyone bringing these forms to the Convention must submit them to the Director of Membership at least ten minutes before the plenary session for which the proxy is required. This page is to be completed by the chapter president if the chapter will not be present for plenary CHAPTER CHAPTER’S NBLSA EMAIL ADDRESS CHAPTER PRESIDENT CHAPTER PRESIDENT’S EMAIL ADDRESS CHAPTER PRESIDENT’S PHONE NUMBER Plenary Session(s) for which proxy is needed1: Session 1
Session 2
Session 3
Session 4
For the 2014 Annual Convention of the National Black Law Students Association, I hereby designate the following chapter as the OFFICIAL VOTING PROXY for _______________ Chapter. NAME OF PROXY HOLDER: ____________________________________________________________ PROXY HOLDER’S EMAIL ADDRESS: PROXY HOLDER’S PHONE NUMBER: PROXY HOLDER’S CHAPTER:
I hereby certify that I am the duly elected President/authorized representative of the _____________________chapter: _____________________________________ 1 If a proxy chapter is needed for less than all plenary sessions please also fill out the Convention Delegate form to assign a delegate for your chapter for those plenary sessions.
SIGNATURE OF CHAPTER PRESIDENT PLEASE SUBMIT TO MEMBERSHIP@NBLSA.ORG BY FEBRUARY 28, 2014. For use by Director of Membership only: Rcvd Date: __________ Rcvd by: __________ Number of Votes: __________ Verified: __________
NATIONAL BLACK LAW STUDENTS ASSOCIATION 46th Annual Convention Voting Rights Assignment CERTIFICATION FOR RECOGNIZED PROXY HOLDER To help facilitate the processing and verification process, this form should be sent to the Director of Membership at membership@nblsa.org by February 28, 2014. After this date, forms should be submitted in person. Anyone bringing these forms to the Convention must submit them to the National Director of Membership at least one hour before the plenary session for which the proxy is required. This page is to be filled in by the RECOGNIZED PROXY HOLDER. The Proxy Holder should email this form to membership@nblsa.org by February 28, 2014 AND bring a copy to plenary. CHAPTER ASSIGNING THE PROXY: NAME OF PROXY HOLDER: PROXY HOLDER’S EMAIL ADDRESS: PROXY HOLDER’S PHONE NUMBER:
I hereby certify that: I am a member in good standing of the _______________ chapter. I have been duly appointed as a PROXY HOLDER for the above named chapter. I understand that it may be revoked at any time by the assigning chapter. _____________________________________
SIGNATURE OF PROXY HOLDER PLEASE SUBMIT TO MEMBERSHIP@NBLSA.ORG BY February 28, 2014.
For use by Director of Membership only:
Rcvd Date: __________ Rcvd by: __________ Number of Votes: __________ Verified: __________