1. r Return by May 1, 2014
CERTIFICATION OF DELEGATES
KENTUCKY ASSOCIATION FFA CONVENTION
Complete and return to: Matt Chaliff, Executive Secretary, Kentucky Association FFA, 500
Mero Street, Room 2023, Frankfort, Kentucky 40601.
This form does not register the members for the FFA Convention; it only allows us to type
delegate badges.
The names of the first two members listed below are the official delegates for the 84th
Annual
Kentucky FFA Convention from the
Chapter of the Kentucky Association FFA. The third member is our alternate.
PLEASE PRINT
Official Delegate: Home Address:
Official Delegate: Home Address:
Alternate: Home Address:
LIST ALL TEACHER(S) ATTENDING
Signed:
Teacher of Agriculture Teacher of Agriculture
Date Teacher of Agriculture
NOTE: Please fill out and return the Convention Registration Form to pre-register for the
Convention. .