2022 IAMAW District 141 Convention Delegate Submission Form

Name of Delegate *

First

Middle

Last

Local Lodge *

Email *

Confirm Email

Please provide a personal email address for the delgate. We can not accept company email addresses.

Delegate Phone Number *

Airline or Company *

Please ask the attendee for their accurate jacket size.

Men's sizes

Women's Sizes

Are there any alternate delegates?

Recording Secretary (Must be submitted by Local Lodge Recording Secretary) *

First

Last

Phone