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GANHS Convention Registration Form

Any chapter planning to attend the convention must first pay the appropriate state dues. The postmark deadline is March 10, 2010. All late registrations require a $10.00 late fee per person, in addition to the regular registration fee. Any substitution made will require a $5.00 substitution fee. Please direct any questions to: Emily Hudson, GANHS President or Destinee Woodruff, GANHS Treasurer.

All payments should be in the form of School Checks.

School Name _____________________________ Mail Forms To: Destinee Woodruff

735 Lost Creek Circle

Stone Mountain, GA 30088

Advisor’s Name ______________________

School Address ______________________

___________________

School Phone ______________________________________

E mail address ____________________________________________________

Total Number of People Attending including State Board ____________________

Total Number of People Attending (Students/Advisors/Chaperones) ___________________ (x $90.00)

Late Fees (If Applicable) ____________________ (x $10.00)

Substitution Fees (If Applicable) ____________________ (x $5.00)

Total Registration Fee _________________

Convention T-Shirts _____ SM _____MED _____ LG _____ XLG _____ XXLG _____ XXXLG

Please Print All Names Clearly

Names of all VOTING DELEGATES (1 per every 10 members, or major fraction thereof)

1. ____________________________________ 7. ____________________________________

2. ____________________________________ 8. ____________________________________

3. ____________________________________ 9. ____________________________________

4. ____________________________________ 10. ____________________________________

5. ____________________________________ 11. ____________________________________

6. ____________________________________ 12. ____________________________________

Name of all NON-VOTING DELEGATES:

1. _____________________ 7. ________________________

2. _____________________ 8. _________________________

3. _____________________ 9. _________________________

4. _____________________ 10. _________________________

5. _____________________ 11. _________________________

6. _____________________ 12. __________________________

Names of ADVISORS AND CHAPERONES: (please specify: 1 per every 10 members) Chaperones must be faculty or parents of students attending. Other chaperones must be approved by State Board.

(Advisor) ___ ____________________________________________________

(Advisor) _______________________________________________________

Additional Chaperones (if applicable _______________________________________

Candidate (if applicable) __________________________________________

Campaign Manager __________________________________________

Name State Board Members Attending _________________________________________ (Registration Fee Exempt)

Name of State Board Advisor Attending _________________________________________

PLEASE NOTE: Candidates, Campaign Managers, and State Board Members may not serve as voting delegates at the convention.