Area Delegate & Alternate Submission

Area Delegate & Alternate Submission

Please use this form to submit your elected Delegates and Alternates. They serve through 12/31/2026. Please email Dusty Siravo at dsiravo@gskentuckiana.org if you have any questions. Thank you!
Name of Area Representative Completing Form*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Area: *
Select the area you wish to designate Delegates/Alternates for
Area Delegate Calculation

Use the chart below to complete the remaining questions on the form below.
- Area Delegates = Please elect the number in the Delegates Total column.
- Area Alternates = Please elect the number of Area Delegates plus 2 for the Area Chair and Area Vice Chair.
- Area Chair and Area Vice Chair should not be listed as an Area Delegate or Area Alternate.
Area Delegate Selection

Please use the form below to submit your area's list of Delegate's and Alternates. Use the "+ Add Delegate" and "+ Add Alternate" buttons to add additional lines as needed for your submission. Please include delegate emails and phone numbers in addition to their name, if known.
Area Delegate*
Area Alternate*
Should be Empty:

Area Delegate Selection