Date : _______________, 20 ___

TO : Lions District 301-D2

Bernardo Park, EDSA, Quezon City

ATTENTION : GOV. RAYMUNDO O. ABUEL, JR., MJF

LIST OF OFFICIAL VOTING DELEGATES

To the 72nd Lions MD 301 State Convention
___________________________

NAME OF CLUB : ________________________________________________________

REGULAR VOTING DELEGATES

Name Email Address Cellphone Number

1. _________________ 1. _________________ 1. _________________
2. _________________ 2. _________________ 2. _________________
3. _________________ 3. _________________ 3. _________________
4. _________________ 4. _________________ 4. _________________
5. _________________ 5. _________________ 5. _________________
6. _________________ 6. _________________ 6. _________________
7. _________________ 7. _________________ 7. _________________
8. _________________ 8. _________________ 8. _________________
9. _________________ 9. _________________ 9. _________________
10. _________________ 10. _________________ 10. _________________

ALTERNATE VOTING DELEGATES

Name Email Address Cellphone Number

11. _________________ 11. _________________ 11. _________________
12. _________________ 12. _________________ 12. _________________
13. _________________ 13. _________________ 13. _________________
14. _________________ 14. _________________ 14. _________________
15. _________________ 15. _________________ 15. _________________
16. _________________ 16. _________________ 16. _________________
17. _________________ 17. _________________ 17. _________________
18. _________________ 18. _________________ 18. _________________
19. _________________ 19. _________________ 19. _________________
20. _________________ 20. _________________ 20. _________________

Certified True and Correct: Attested by:

__________________________ __________________________
Club President – LY 2020-2021 Club Secretary – LY 2020-2021
Deadline for submission of Voting Delegates is on: May 7, 2021
Important:

Original : District Office

Duplicate : Club File
Submit through E-mail : lionsclubs301d2@yahoo.com
Master List E-mail : Jamir Caaway - jamir_nine@yahoo.com

NOTE : To qualify as Voting Delegates, your club must settle all unpaid International Dues / District Dues, and
Club Roster. Deadline for payments is on May 7, 2021. For more information please call District Office 352-
2951.

Deadline for payments on MD 391 Voting Delegates of P 500 will be on or before May 10, 2021.