2021 State Convention Delegate Filing Form
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*YOU MUST BE A RESIDENT OF THE CITY OF LYNCHBURG TO FILE THIS FORM*
By clicking "Submit" I further certify that all of the information contained in this form is true and accurate, that I am the individual named in this form and that my certification shall serve as a digital signature made by my hand.
The deadline to submit this form is 8:00 PM EDT on Monday, April 19, 2021