EmailMe Form - NBA Region Certification Form

Region Certification Form
(See NBA Constitution, Article VII, Section 3.B and NBA By-Laws Chapter VI, Section 2).

This is to certify that the following region met on the following day for its annual meeting and the following person, who is a regular member of the Association, was elected to represent the Region on the NBA Board of Governors.

Region Name

Name/Newly-Elected Regional Director *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

Office Number *

### - ### - ####

Home Number *

### - ### - ####

Name *

First Last

Date *

MM / DD / YYYY

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Region Certification Form (See NBA Constitution, Article VII, Section 3.B and NBA By-Laws Chapter VI, Section 2).

Region Certification Form
(See NBA Constitution, Article VII, Section 3.B and NBA By-Laws Chapter VI, Section 2).