Convention Registration 2013

GANHS Convention Registration Form

                Any chapter planning to attend the convention must first pay the appropriate state dues. The postmark deadline is March 29, 2013.  All late registrations require a $10.00 late fee per person, in addition to the regular registration fee. Any substitution made will require a $5.00 substitution fee.  Please direct any questions to:  Hannah Taylor, State President  hannah.taylor9254@gmail.com

All payments should be in the form of School Checks.

School Name        _____________________________                            Mail Forms To:   Alfredia Braylark

4640 Raiders Ridge Lane

Lithonia, GA 30038                            

Advisor’s Name  ______________________                                                  

School Address   ______________________                               

                   ___________________       

School Phone       ______________________________________                                                      

E mail address     ____________________________________________________

Total Number of People Attending including State Board          ____________________

Total Number of People Attending (Students/Advisors/Chaperones)      ___________________ (x $90.00)

Late Fees (If Applicable)                                                                   ____________________ (x $10.00)

Substitution Fees (If Applicable)                                                      ____________________ (x $5.00)

Total Registration Fee                                                                                        _________________

               

      Convention T-Shirts     _____ SM   _____MED    _____ LG   _____ XLG  _____ XXLG     _____ XXXLG

Please Print All Names Clearly

Names of all VOTING DELEGATES (1 per every 10 members, or major fraction thereof)

1.   _______________________________________                               7.   _________________________________________   

2.   _______________________________________                8.  __________________________________________    

3.   _______________________________________                9.  __________________________________________    

4.   _______________________________________               10.  __________________________________________    

5.   ________________________________________            11.  __________________________________________    

6.   __________________________________________        12.  __________________________________________    

Name of all NON-VOTING DELEGATES:

1.    _____________________         7.   ________________________

2.   _____________________           8.  _________________________

3.   _____________________           9.  _________________________

4.   _____________________         10.  _________________________

5.   _____________________         11.  _________________________  

6.   _____________________         12.  __________________________  

Names of ADVISORS AND CHAPERONES: (please specify: 1 per every 10 members) Chaperones must be faculty or parents of students attending. Other chaperones must be approved by State Board.

(Advisor)               ___ ____________________________________________________  

(Advisor)               _______________________________________________________  

Additional Chaperones (if applicable _______________________________________

Candidate (if applicable)   __________________________________________   

Campaign Manager                            __________________________________________   

Name State Board Members Attending                          _________________________________________ (Registration Fee Exempt)   

Name of State Board Advisor Attending                        _________________________________________  

PLEASE NOTE: Candidates, Campaign Managers, and State Board Members may not serve as voting delegates at the convention.