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Designated Representative Voting Form
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  The administrator or governing body of each Regular Member shall specify in writing a Designated Representative affiliated with that Regular Member facility to sit as a member of the House of Delegates. The facility may change such representative at any time by written communication to the President at least forty-eight (48) hours prior to a convening of the House of Delegates.

Deadline to Submit Designated Representative Form to GHCA Monday, June 12, 2017 at 8:30 a.m.

Credentials of the Designated Representative or Alternate Representative must be properly certified by the Credentials Committee prior to any convening of the House of Delegates. The Credentials Committee shall establish and publish the deadline for presentation of credentials for certification.

The individuals shown below will be considered Designated Representative and Alternate Designated Representative to the facility below unless changed in accordance with the Bylaws:

  I am authorized to make the changes to the facility's designated and alternate representative:
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