Annex C - Rep Member

ANNEX C: Charter - COUNCIL ON YOUTH

LEADERSHIP DEVELOPMENT

in NORTHERN ITALY

Representative Member Commitment Form

Name of Organization:

Address:

Date:

We the members and officers of the above-written organization do hereby nominate the following persons as representatives of our organization in the Council on Youth Leadership Development in Northern Italy.

First Nominee:

Second Nominee:

We have read and understood the Charter of the Council on Youth Leadership Development in Northern Italy and wholeheartedly agree with its vision and shall fully support its objectives and activities.

We collectively conform and subscribe to the Charter of the Council on Youth Leadership Development in Northern Italy and shall humbly abide to the decisions and resolutions of the Council.

We are also in the knowledge that our organization is not in any manner under the supervision or control of the Council and we shall only support Approved Resolutions that are within the bounds of the Charter of the Council.

Our representatives are not members acting in their individual capacities but are the authorized representatives of our organization to the Council and shall act in our behalf.

Particulars

First Representative

Name as written in Passport

Passport Number

Date and Place of Issue

Current Address in Italy

Second Representative

Name as written in Passport

Passport Number

Date and Place of Issue

Current Address in Italy

We execute this Representative Member Commitment form as a consequence of the meeting of the majority of the members and officers of our organization called for this purpose.

Signature of First Representative

Signature of 2nd Representative

President/Authorized Signatory

To be accomplished by the Membership Committee:

Copy of Charter provided to the member/s

Manifesto signed by the member/s

Member/s written in the roster of membership

Others: