Young Republican Federation of Virginia 66th Annual Convention April 20th, 2013

Location: Baileys Pub & Grille 4238 Wilson Blvd. Arlington, VA 22203

OFFICIAL DELEGATE REGISTRATION FORM

Delegates are encouraged, but not required, to contribute $35 as a suggested filing fee. There is no mandatory fee to attend the 2013 YRVF Convention; however, proceeds from suggested filing fees will go toward Convention expenses. Non-Delegates will not be allowed into the business portion of the Convention. [__] YES! I will pay the suggested (but not mandatory) filing fee of $35 and will attend the Convention as a: [__] Full Delegate [__] Non-Delegate [__] NO! I will not pay the suggested fee, but I will attend the Convention as a: [__] Full Delegate [__] Non-Delegate

Name_________________________________________________________________________ Street Address__________________________________________________________________ City/State/Zip_____________________________________________________________________ Home Phone__________________________ Work Phone__________________________________ E-mail___________________________________________________________________________ YR Club__________________________________________________________________________ Congressional District #______________________ Date of Birth____________________________
Please fill out this form and submit it to Chairman of the YR group of which you are a current, dues-paying member. Each club is responsible for submitting a list of delegates to the Federation Chairman by certified mail or authenticated email no later than seven (7) days prior to the Convention. Furthermore, B. Only Active Club Members may be delegates. C. In addition to the names of delegates, the Chair shall list the Congressional District in which the delegate is registered to vote. (Individuals MUST be registered to vote and reside in their locality to serve as Delegates.) D. Substitutions may be made upon approval of the Credentials Committee. E. Only Clubs which hold charters as of March 15th may send delegates to the Annual Convention. DISCLAIMER: I understand that the YRFV is obligated to turn in the number of attendees and meals prior to the event. I understand that the YRFV is held responsible for meals ordered and additional room rental fees based on these numbers. I understand that the information that I have provided will be used to calculate these totals. The YRFV reserves the right to refuse entrance and registration from any non-member of the YRFV. Please email Matthew Burrow, Chairman of the Credentials Committee, with any questions: matthewaburrow@gmail.com