Certification of Sergeant-At-Arms & Alternates

Certification of Sergeant-At-Arms and Alternates

Sergeant-At-Arms

Sergeant-At-Arms 1 Name:(Required)
Sergeant-At-Arms 1 Address:(Required)
Sergeant-At-Arms 2 Name:(Required)
Sergeant-At-Arms 2 Address:(Required)

Alternates

Alternate 1 Name:(Required)
Alternate 1 Address:(Required)
Alternate 2 Name:(Required)
Alternate 1 Address:(Required)

Certification

Name of Club Officer Completing Form:(Required)
Office held (only Club President or Secretary allowed to submit form)L
MM slash DD slash YYYY

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