2026 Lifelong Learning & Service Recognition (LLSR) Convocation Reply Form

Please complete this form by Friday, May 1, 2026. Email education@agd.org if you have any questions.

Convocation attendance is not mandatory for LLSR Recipients

AGD Member ID

First Name

Constituent Name

Middle Initial

Last Name

Please write out the name of your constituent, do not put the regional number.

Select preferred option

I WILL attend Convocation Ceremony June 27, 2026, in Las Vegas, Nevada

I WILL NOT attend Convocation Ceremony June 27, 2026, in Las Vegas, Nevada – if you are not attending, please confirm your shipping address to send your LLSR Crystal.

Please confirm how you would like your name to appear on your LLSR Crystal and Honor Stole: Note: There is a space limit on the crystal and honor stole.

Please confirm your mailing address to receive your LLSR Crystal and other items. Shipping addresses must be updated at least 4 weeks before the convocation ceremony.

Name

Address

City

State/Providence

Zip Code

Is your spouse or other family member receiving the LLSR:

Yes

If yes, please enter the name and the relation of the person.

How many guest(s) will you invite to the Convocation Ceremony?

Guest #1

Guest #2

Guest #3

Guest #4

Guest #5

Family members receiving different awards/recognitions cannot be seated together, but AGD staff will provide direction so you can have your photos taken together on-stage with the AGD president.

Sponsored by AGD Corporate Sponsors:

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