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County Name: <br /> <br />Name of Designated Delegate: <br /> <br />Name of First Alternate: <br /> <br />Name of Second Alternate: <br /> <br />Signature ' <br /> <br />Date <br /> <br />NACo 2000 CREDENTIALS IDENTIFICATION FORM <br /> <br /> State: <br /> <br /> County is voting'by proxy. (check box) <br />(County must have one paid registration for the 'conference in order to vote by proxy.) <br /> <br /> Title: <br /> Title: <br /> Title: <br /> Title <br /> <br />Commissioner/Supervisors/Board Member Signature <br /> <br />We do not want the State Association Representative to pick up our Credentials Material. (check box) <br /> <br />Mail it to: <br /> <br />Please return this form to NACo by MONDAY, JUNE 19. <br /> <br /> Credentials Committee <br /> c/o Susan Parrish <br />National Association of Counties <br />440 First Street, N.W. <br />Washington, DC 20001 <br /> <br />Fax it to: <br /> <br />To: <br /> <br />Fax #: <br /> <br />From: <br /> <br />Susan Parrish <br />202/393-2630 <br /> <br />OR <br /> <br />Sender's Phone #: <br /> <br /> <br />