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LTE AG U E� <br />bL-C <br />CITY: <br />2017 ANNUAL CONFERENCE <br />VOTING DELEGATE/ALTERNATE FORM <br />Please complete this form and return it to the League office by Friday, September 1, 2017. <br />Forms not sent by this deadline may be submitted to the Voting Delegate Desk located in <br />the Annual Conference Registration Area. Your city council may designate one voting <br />delegate and up to two alternates. <br />In order to vote at the Annual Business Meeting (General Assembly), voting delegates and alternates must <br />be designated by your city council. Please attach the council resolution as proof of designation. As an <br />alternative, the Mayor or City Clerk may sign this form, affirming that the designation reflects the action <br />taken by the council. <br />Please note: Voting delegates and alternates will be seated in a separate area at the Annual Business <br />Meeting. Admission to this designated area will be limited to individuals (voting delegates and <br />alternates) who are identified with a special sticker on their conference badge. This sticker can be <br />obtained only at the Voting Delegate Desk. <br />1. VOTING DELEGATE <br />Name: <br />Title: <br />2. VOTING DELEGATE - ALTERNATE 3. VOTING DELEGATE - ALTERNATE <br />Name: <br />Title: <br />PLEASE ATTACH COUNCIL RESOLUTION DESIGNATING VOTING DELEGATE <br />AND ALTERNATES. <br />OR <br />ATTEST: I affirm that the information provided reflects action by the city council to <br />designate the voting delegate and alternate(s). <br />Name: <br />E-mail <br />Mayor or City Cleric Phone: <br />(circle one) (signature) <br />Date: <br />Please complete and return by Friday, September 1, 2017 <br />League of California Cities <br />ATTN: Carly Shelby <br />1400 K Street, 4th Floor <br />Sacramento, CA 95814 <br />FAX: (916) 658-8240 <br />E-mail: eshelby@cacities.org <br />(916) 658-8279 <br />65A-6 <br />