Return to: - Ohio School Boards
Return to: ORIGINAL
Ohio School Boards Association Return no later than:
8050 N. High St., Suite 100 September 11, 2017
Columbus, Ohio 43235-6482
(614) 540-4000 / (614) 540-3299
The______________________________________________________________ School District
Board of Education of _______________________________________________ County hereby
appoints __________________________________________________ as the delegate to
(name of delegate)
the 2017 OSBA Annual Business Meeting and in the event the delegate cannot serve,
____________________________________________________ has been appointed as
(name of alternate)
alternate. The delegate and alternate were appointed at the meeting of the board of education on
_________________________________.
(date)
SIGNATURES MUST BE ON ALL COPIES TREASURER’S CERTIFICATION
_______________________________________ _______________________________
Signature of delegate Signature of treasurer
____________________________________ _____________________________
Home address (Please print this line) School district
____________________________________ _____________________________
Signature of alternate County
____________________________________ _____________________________
Home address (Please print this line) District address
_____________________________
E-mail address
FOR OSBA OFFICE USE ONLY
Registration Fee: $____________ received _____________________________ by _________
Return to: TREASURER’S COPY
Ohio School Boards Association RETAIN FOR YOUR
8050 N. High St., Suite 100 RECORDS
Columbus, Ohio 43235-6482
(614) 540-4000 / (614) 540-3299
The______________________________________________________________ School District
Board of Education of _______________________________________________ County hereby
appoints __________________________________________________ as the delegate to
(name of delegate)
the 2017 OSBA Annual Business Meeting and in the event the delegate cannot serve,
____________________________________________________ has been appointed as
(name of alternate)
alternate. The delegate and alternate were appointed at the meeting of the board of education on
_________________________________.
(date)
SIGNATURES MUST BE ON ALL COPIES TREASURER’S CERTIFICATION
_______________________________________ _______________________________
Signature of delegate Signature of treasurer
____________________________________ _____________________________
Home address (Please print this line) School district
____________________________________ _____________________________
Signature of alternate County
____________________________________ _____________________________
Home address (Please print this line) District address
_____________________________
E-mail address
................
................
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