LIONS CLUBS INTERNATIONAL

MULTIPLE DISTRICT 317

Fifteenth Annual Multiple District Convention

26TH May 2024
Certified Voting Delegate Form

Club Name ………………………………………………………………..

District……………………………………

Sl Delegate Signature Sl Alternate Delegate Signature

No No
1 name 1 name

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

Club President’s Signature Club Secretary’s Signature.

Send all voting delegate forms to your respective District Governor

Respective District Governor to update the following.

Lion B S Rajashekaraiah
Credential Committee Chairperson
Mob: 9980936263