INTRODUCTION On April 8, 2014, the Canadian Deaf Sports Association has officially opened bidding to Host the 2016 Canada Deaf Games (Summer). For more information regarding the event please refer to section 2.1 to 2.4. RIGHTS HOLDER The Canadian Deaf Sports Association is a pan Canadian non-profit organization aiming to support the development of the practice of sports within the Deaf community, particularly the Deaf youth, in order to ensure a quality Canadian representation at Deaflympics and Pan-American Deaf Games. The organization was incorporated in 1964 under the name “Federation of Silent Sports of Canada Inc” and now operates as a registered charity under the name of Canadian Deaf Sports Association with the National Office located in Montreal, QC. The Canadian Deaf Sports Association is a National Multisport Federation with a membership consisting of 7 Provincial Deaf Sports Associations, 3 National Deaf Sport Organizations, several National Deaf Sport Committees and Advocacy Groups and offering National programs for 25 eligible Sports. CDSA is also one of 107 National Deaf Sports Federations which are members of the International Committee of Sports for the Deaf who acts as the supreme authority for the Deaflympics movement, and the governing body over all International Deaf Sport Competitions. The CDSA Board of Directors consists of representatives from across Canada, and holds 4 Standing committees and 2 working groups which help to establish direction. CDSA’s Objectives are:

• To encourage the development and affiliation of Provincial and Territorial Deaf Sports Associations (PDSAs) within Canada;

• To encourage the development and affiliation of National Deaf Sports Organizations (NDSOs) within Canada;

• To select and train, with the assistance of the PDSAs, NDSOs and Sport Committees, deaf athletes who meet the requirements for participating in International competitions, specifically the Deaflympics, Pan-American Games for the Deaf and World Championships;

• To promote and facilitate the practice of amateur sports among deaf athletes in Canada; and

• To promote and facilitate High Performance sport programs for the Deaf community of all ages within Canada as stipulated in CDSA's standards.

Vision : Sport is a source of well-being, values and self-esteem for people who practice it. The Canadian Deaf Sports Association, by its actions, contributes in spreading its benefits through the Deaf community across Canada. For further information, please contact Craig Noonan, CEO, Canadian Deaf Sports Association by telephone at (514) 321-8686, or via e-mail at craig.noonan@assc-cdsa.com or; visit our website at: www.assc-cdsa.com

2.1. Description of the Event

• The Canada Deaf Games is the only National Multisport Games for Canadian Deaf Athletes, and offers a key development opportunity for training and selection of future National Team Athletes. The event is held biennially, alternating between Summer and Winter. For many sports, the Canada Deaf Games represents the only National level competition in their sport. The first Canada Deaf Games were held in 2012 in Edmonton, Alberta with 230 Athletes participating in 6 Sports. The event lasted 8 days, with the age of participants ranging between 16-50 years. Athletes from 9 Provinces participated, and overall the event was a resounding success and a major step for Deaf Sport in Canada.

The 2012 Canada Deaf Games brought in approximately 2000 visitors to the city of Edmonton, and finished with a surplus of more than $35,000. The economic impact is estimated at around $1M.

• Access to post event reports and/or financial statements from the 2012 Canada Deaf

Games is granted upon request only, and interested parties can contact the CEO of the CDSA, Craig Noonan at craig.noonan@assc-cdsa.com for further information.

2.2. Eligible Sports The Canada Deaf Games follows the model of the Deaflympic Games, and offers the opportunity for athletes to participate in a variety of sports that are officially sanctioned by the International Committee of Sports for the Deaf. The following is a list of the sports eligible for participation in the 2016 Canada Deaf Games. Bid Communities should indicate all sports that they have the capacity to accommodate as part of the 2016 Canada Deaf Games:

Athletics Mountain Biking Badminton Soccer Basketball Swimming Beach Volleyball Taekwondo Bowling Table Tennis Cycling Tennis Golf Volleyball Judo Wrestling Karate

2.3. Other Activities related to the Event As part of the Canada Deaf Games, the following activities are considered to be obligations of the event: • Opening/closing ceremonies; • Cultural Festivals, or cultural activities(tailored toward the Deaf Community)

As part of the Canada Deaf Games, the following activities are considered to be optional activities of the event: • Exhibitions, fairs; • Social functions including final banquet; • Clinics and workshops related to the event (for the athletes and/or coaches ); • Conferences and conventions

2.4. Specialized Personnel

As part of the Canada Deaf Games, it is expected that the Host Committee will provide an adequate pol of volunteers in order to support the successful and safe operations of the event. Along with the pool of volunteers, it is expected that the Host Committee will provide an adequate supply of licensed ASL and LSQ interpreters in order to ensure the smooth operations of the event and effective communication for its participants. These Interpreters may be a mixture of volunteers and contracted staff. Please note that Teams will be required to supply their own interpreters, but the Host should be equipped to provide Interpretation services to components of the event which fall outside of the “field of play” during competition. For Clarification, please contact Canadian Deaf Sports Association’s CEO, Craig Noonan at craig.noonan@assc-cdsa.com.

3 OBLIGATIONS

3.1. Mandatory commitments

The following mandatory commitments from a bidding community are required. If your bidding community cannot respect the following mandatory commitments, your bid will be refused: • Bid application with answers to all questions and all requested appendices. Bid

communities cannot modify the existing text in appendices (f) to (i); • Signature of the bid committee and bid institutions in appendix (i) of the Bid

application*; • Commitment letters signed by bid institutions stating the type of support they will

offer for the event; • Support letter signed by the provincial deaf sports organization and/or provincial

sport organization; • Bid communities accept that their responses to the bid application be made public at

the discretion of the Canadian Deaf Sports Association after the nomination of the hosting community;

Note*: In order to submit a bid to host the 2016 Canada Deaf Games, appendix (i) of the bid application must be signed by both of the following parties: • the Bid Committee represented by a non-profit organization, registered club or

Provincial Branch; • and one of the following Bid institutions: University, Tourism Office or Municipality.

3.2. Obligations

Bidding communities will be required to abide by the Bylaws and Constitution of the Canadian Deaf Sports Association, which can be found at online at www.assc-cdsa.com. For the event obligations, please refer to: • appendix 2 for the bidding community obligations; • and appendix 3 for the rights holder obligations.

4 BID PROCEDURE The process of selecting the host community is focused on one primary objective: to select the best community to receive the right to host the 2016 Canada Deaf Games. The Canadian Deaf Sports Association reserves the right not to award the event to any bidding communities if they so decide. April 8, 2014 The Canadian Deaf Sports Association opens candidature for the 2016

Canada Deaf Games. The RFP for bidding is made public, and potential Bidding communities are sent an invitation letter.

May 9, 2014 Deadline for potential bidding communities to send their letter of interest

to The Canadian Deaf Sports Association, indicating their intention to bid to host.

May 12, 2014 The Canadian Deaf Sports Association informs all bidding communities

which have forwarded letter of interest that from this point forward, The Canadian Deaf Sports Association will respond to individual questions by potential bidding communities by sending responses to all bidding communities.

June 30, 2014 Deadline for bidding communities to send their bid document to The

Canadian Deaf Sports Association by filling out the Bid application (see appendix 4).

July 15, 2014 The Canadian Deaf Sports Association informs each bid community whether

their bid has met the mandatory commitments and whether their bid is accepted or not. The Canadian Deaf Sports Association issues a communiqué with the names of the bidding communities.

August 15, 2014 The Canadian Deaf Sports Association’s Evaluation Committee members

study the various bid proposals and score each topic of the bid application individually for each bid (see section 6 – Bid Evaluation).

August 31, 2014 The Canadian Deaf Sports Association’s Evaluation Committee meets in

order to recommend to the Canadian Deaf Sports Association’s Board of Directors the best community to host the 2016 Canada Deaf Games.

September 1, 2014 The Canadian Deaf Sports Association’s president announces the host

community for 2016 Canada Deaf Games via conference call or communiqué.

5 BID RULES

5.1. Confidentiality

Confidential information is defined as any document marked "confidential" and which requires secure storage and limited reproduction and distribution. Potential bidding communities should not use the information for any purpose other than to prepare their Bid for the 2016 Canada Deaf Games. Confidential information should not be transmitted to parties not involved in the process, including members of the media.

5.2. Guiding principle

The Canadian Deaf Sports Association believes the procedures for determining the host community, from the initial expression of interest in the bid to the selection of the host community, should be based on an open dialogue and fair process for all bidding communities. This process shall be conducted in an ethical manner, including but not limited to the following qualities: fairness, openness, transparency, equity and respect for all bidding communities.

5.3. Bid document

To minimize the costs of submitting a proposal, The Canadian Deaf Sports Association requires that proposal documents be produced in-house on letter-size paper and spiral bound, or bound using some other inexpensive method. 10 of copies should be delivered to The Canadian Deaf Sports Association - 10217 boul. Pie IX, Suite 202 A, Montreal-Nord, QC, H1H 3Z5 - not later than June 30, 2014 at 5:00 pm Eastern Standard Time. An electronic copy of the bid must also be submitted. The numbering within the bid application must be maintained and a table of contents must be included at the beginning of the bid application. The questions must be included in the bid application submitted to The Canadian Deaf Sports Association.

5.4. Communication

Potential bid communities or bid communities must address all questions in writing to the Canadian Deaf Sports Association, who will forward the replies to all potential bid communities. No contact should be made with the Federal Government. No formal or informal presentation or meeting in any way relating to the bid shall be held with the Canadian Deaf Sports Association’s Board of Directors, Evaluation Committee or staff, other than the one described in section 4.

No gifts or tokens of appreciation of any kind shall be offered to the Canadian Deaf Sports Association’s Board of Directors, Evaluation Committee or staff. The Canadian Deaf Sports Association’s logo may not be used in any documentation of the bidding communities.

6 BID EVALUATION

The Canadian Deaf Sports Association will nominate 8 Evaluation Committee members to review all bids. Each member will review each bid application and score each topic individually (see appendix 3).

Weighting %

1 Background 10

2 Support and partnerships 10

3 Facilities 10

3.1 Sporting facilities 5 3.2 Non-sporting facilities (for accommodation see 7.1) 5

4 Competition 5

5 Finance (including revenue generation) 15

5.1 Financial risk assessment (including detailed budget and confirmed revenues)

5

5.2 Broadcasting plan 5 5.3 Marketing plan 5

6 Communication, hosting services and other activities 15

6.1 Communication plan 6 6.2 Media services during the event 3 6.3 Hosting services (VIPs and sponsors) 3

6.4 Other activities related to the event: Opening/closing/special events/final banquet/festival

3

7 Operation 20

7.1 Accommodation 4 7.2 Registration and accreditation 2 7.3 Airport including shuttle 2 7.4 Local transportation 4 7.5 Medical 2 7.6 Security including access control 2 7.7 Official languages 2 7.8 Technology 2

8 Legacy 5

9 Overall Bid presentation 10

APPENDIX 1 - BIDDING COMMUNITY OBLIGATIONS

1 GENERAL INFORMATION 2 SUPPORT AND PARTNERSHIPS 3 FACILITIES 3.1 Sporting facilities (including competition and training) 3.2 Non-sporting facilities (for accommodation see 7.1) 4 COMPETITION 5 FINANCES INCLUDING REVENUE GENERATION 5.1 Finances 5.2 Broadcasting 5.3 Marketing 6 COMMUNICATION, HOSTING SERVICES AND OTHER ACTIVITIES 6.1 Communications 6.2 Media services during the event 6.3 Hosting services (VIPs and sponsors) 6.4 Other activities related to the event (opening/closing ceremonies, special activities, final

banquet, and festival)

7 OPERATIONS 7.1 Accommodation 7.2 Registration and accreditation 7.3 Airport (including shuttles) 7.4 Local transportation 7.5 Medical 7.6 Security including access control 7.7 Official languages 7.8 Technology 8 LEGACY

APPENDIX 2 - RIGHTS HOLDER OBLIGATIONS 1 GENERAL INFORMATION 2 SUPPORT AND PARTNERSHIPS 3 FACILITIES 3.1 Sporting facilities (including competition and training) 3.2 Non-sporting facilities (for accommodation see 7.1) 4 COMPETITION 5 FINANCES INCLUDING REVENUE GENERATION 5.1 Finances 5.2 Broadcasting 5.3 Marketing 6 COMMUNICATION, HOSTING SERVICES AND OTHER ACTIVITIES 6.1 Communications 6.2 Media services during the event 6.3 Hosting services (VIPs and sponsors) 6.4 Other activities related to the event (opening/closing ceremonies, special activities, final

banquet, and festival)

7 OPERATIONS 7.1 Accommodation 7.2 Registration and accreditation 7.3 Airport (including shuttles) 7.4 Local transportation 7.5 Medical 7.6 Security including access control 7.7 Official languages 7.8 Technology 8 LEGACY

APPENDIX 3 - BID APPLICATION TO BE RETURNED TO RIGHTS HOLDER Bidding communities will be evaluated by The Canadian Deaf Sports Association’s Evaluation Committee on the basis of each of the topics below. Certain topics will have more importance than others; please see section 6 – Bid Evaluation for more information.

1 BACKGROUND 1.1 Please describe your bidding community. 1.2 Please outline the meteorological climate for the proposed event date. 1.3 Which sporting events and non-sporting events has your bidding community

hosted previously? 1.4 Who will Chair the Organizing committee? Who are the potential members of the

LOC? What will be their role and what is their event background?

2 SUPPORT AND PARTNERSHIPS

2.1. Who will be the event promoter and the event partners/stakeholders? 2.2. Have you received any commitments from various local, regional, provincial or

federal governments, organizations or institutions? 2.3. What is your staffing plan for planning this event if you are selected as the host

community?

3 FACILITIES 3.1. Do the existing competition sites and facilities comply with or exceed Canadian

Deaf Sports Association’s obligations (not including technical rules and regulations)?

3.2. Do the existing competition sites and facilities, including the equipment, comply with or exceed Canadian Deaf Sports Association’s the technical rules and regulations?

3.3. Do the existing competition sites and facilities, including the equipment, comply with or exceed Canadian Deaf Sports Association’s rules and regulations?

3.4. Do your non-sporting facilities (not including accommodations) comply with or exceed Canadian Deaf Sports Association’s obligations?

3.5. Will any venues require a capital upgrades budget and if the answer is yes, do you have confirmation of funding and a confirmed construction timetable?

4 COMPETITION

4.1. Who will be the competition management team for the event and what is their

background? 4.2. How many major competition officials (who can officiate as per technical

regulations) do you have in your region who will not require accommodation?

5 FINANCES INCLUDING REVENUE GENERATION

5.1. Please elaborate on the event's financial risk assessment following the production

of your operational budget for the event. 5.2. Do you intend to have the event webcast/broadcast? If yes, please give details in

the webcasting/broadcasting plan as well as the type of support the Organizing Committee will provide to the webcaster/broadcaster.

5.3. Please outline your marketing plan (sponsorships, ticketing, merchandising and fundraising). How will you be able to raise commercial revenues factoring in the marketing obligations?

6 COMMUNICATION, HOSTING SERVICES AND OTHERS ACTIVITIES

6.1. Please outline your communication plan factoring in the communication

obligations. More specifically how can you ensure that many spectators will be present?

6.2. What type of services to the media do you intend to provide during the event? 6.3. What type of hosting services do you intend to provide to VIPs and sponsors? 6.4. Do you intend to organize other activities related to the event such as opening /

closing ceremonies, special events, final banquet or a festival? 7 OPERATIONS

7.1. Do your accommodations facilities comply with or exceed the Canadian Deaf

Sports Association’s obligations and what type of services do you intend to provide at the various accommodation sites?

7.2. Please outline your registration / accreditation plan. 7.3. Please outline your airport plan including airport shuttles. 7.4. Please outline your local transportation plan. 7.5. What type of medical services do you intend to provide, and where? 7.6. Please describe the security access control plan at the venues. 7.7. What will be your official language plan for this event? 7.8. Please describe the technology infrastructure that will be available at the venues.

8 LEGACY AND CONCLUSION

8.1. What type of legacy will this event leave at the local, regional, provincial and

national level? 8.2. Why should we select your community to host this event?

APPENDICES Bidding communities need to include the following appendices: Appendix A Bidding community site map with all venue locations Appendix B Competition site floor plan and photos Appendix C Training site floor plan and photos Appendix D Accommodation photos Appendix E Operational budget

Appendix F (bid application) - Hotel forms (one per hotel)

GENERAL INFORMATION

Hotel name: Owner: Address:

Telephone: Web site: Opening year: Last renovation:

CAPACITY

Capacity Booked Costs + tax (without breakfast) Single (1 bed) Double (1 bed) Twin (2 beds) Triple (2 beds) Quad (2 beds) Junior suite Suite Presidential suite

CHARACTERISTICS

No. of stars: No. of meeting rooms (also incl. total square meters):

No. of restaurants: No. of bars

Services available in the rooms

Services available in the hotel

Outdoor space for temporary structures (details and square meters)

TRANSPORTATION

Distance (km) to airport: No. of minutes: Distance (km) to downtown: No. of minutes: Distance ( km) to competition site: No. of minutes: Parking (no. of spots) Cars: Buses: Pick up / Drop off (no. of spots available)

Cars: Buses:

Distance from public transportation stops:

Canadian Sport Tourism Alliance • Request for Proposal Template

Appendix G (bid application) - Competition venue form

COMPETITION VENUE FORM

VENUE GENERAL INFORMATION Venue name Owner's name Address Telephone Contact name / position Venue website address Year of construction Year of last major renovation(s) Number of floor(s) Venue rental cost

MARKETING ASPECTS YES NO N/A NUMBER REMARKS Does the venue have permanent advertising board(s)? - Please specify where Does the venue have an agreement with a concessionaire who has exclusivity? If yes, what is the last year of the contract? Does the venue have beverage vending machine(s)? Does the venue have product exclusivity? - If yes, specify which one, and when this exclusivity expires.

FIELD OF PLAY INFORMATION Competition Warm up REMARKS

nº 1 nº 2 nº 3 Name Size (within the competition area) Size (wall to wall) Height Floor (type) Seating capacity (permanent)

Canadian Sport Tourism Alliance • Request for Proposal Template

Seating capacity (temporary) Existing sound system (give specifications in remarks) Existing scoreboard/video board (give specifications in remarks) Lights (foot candles) AC or Ventilation

WORKROOM(S) THAT CAN BE USED FOR EVENT OPERATION

NAME SIZE FLOOR LEVEL

FLOOR TYPE

REMARKS

Indoor room(s) (owner to create one line per room) Outdoor field(s) (owner to create one line per field) Outdoor space(s) (owner to create one line per space)

ATHLETES & OFFCIALS SERVICES YES NO N/A NUMBER REMARKS

(please specify room size and room name)

Team dressing room Shower(s) Washroom(s) Technical officials' / referees' dressing room(s) Medical room

SPECTATORS/MEDIA/VIP SERVICES YES NO N/A NUMBER REMARKS

(please specify room size) Spectators' entrance / hall Ticketing office (no. of booths) Spectators' washrooms (built to service how many spectators?) Spectators' restaurant(s) Spectators' snack bar(s) Spectators' elevator(s) - for disabled persons Merchandising sales area(s) VIP area Media area

Canadian Sport Tourism Alliance • Request for Proposal Template

TRANSPORTATION YES NO N/A NUMBER REMARKS Parking (car) Parking (buses) Drop off /pick up load zone (no. of cars at the same time) Drop off /pick up load zone (no. of buses at the same time) Loading dock Equipment elevator(s) Public transportation (specify distance to bus stop in remarks column) WILL THE FACILITY RENTAL INCLUDE THE FOLLOWING

FACILITIES, EQUIPMENT OR SUPPLIES AT NO EXTRA CHARGE?

YES NO NOT

AVAILABLE

IF NO, COSTS

PER DAY REMARKS

Number of competition day(s) (please specify how many) Number of fit-out and decommissioning days (please specify how many) Access to the venues prior to fit-out days during non-exclusivity period Provide a clean venue with no advertisement board All the rooms specified above All the outdoor field(s) / space(s) specified above Sport equipment (please specify in remarks column) Timing and results equipment (please specify in remarks column) Furniture, fixtures and equipment (FF&E) (Please specify in remarks column) Electricity consumption Waste management Parking during the event Parking prior to the event

Canadian Sport Tourism Alliance • Request for Proposal Template

DO THE FACILITY RENTAL COSTS INCLUDE THE FOLLOWING SERVICES AT NO EXTRA CHARGE?

YES NO SERVICE

NOT AVAILABLE

IF NO, COSTS

PER HOUR

REMARKS (please specify here if this service has to be provided by the owner because

of exclusivity clauses) Janitorial services for existing room in building Janitorial services for spectators’ area including permanent spectators’ seating Janitorial services for outdoor field Field maintenance Plumber services Electrician services Manpower services Sound technician(s) Scoreboard / video technician(s) Telecommunication technician(s) Receptionist service Security personnel

Appendix H (bid application) - Training venue form

TRAINING VENUE FORM

VENUE GENERAL INFORMATION Venue name Owner's name Address Telephone Contact name / position Venue website address Year of construction Year of last major renovation(s) Number of floor(s) Venue rental cost

MARKETING ASPECTS YES NO N/A NUMBER REMARKS Does the venue have permanent advertising board(s)? - Please specify where Does the venue have beverage vending machine(s)? Does the venue have product exclusivity? - If yes specify, and when this exclusivity expires.

TRAINING FIELD OF PLAY INFORMATION nº 1 nº 2 nº 3 nº 4 REMARKS Name Size (within the competition area) Size (wall to wall) Height Floor (type) Lights (foot candles) AC or Ventilation

WORKING ROOM(S) WHICH CAN BE USED

FOR EVENT OPERATION NAME SIZE

FLOOR LEVEL

FLOOR TYPE

REMARKS

Indoor room(s) (owner to create one line per room) Outdoor field(s) (owner to create one line per field) Outdoor space(s) (owner to create one line per space)

ATHLETES & OFFCIALS SERVICES YES NO N/A NUMBER REMARKS

(please specify room size and room name)

Team dressing room Shower(s) Washroom(s) Medical room

TRANSPORTATION YES NO N/A NUMBER REMARKS Parking (car) Parking (buses) Drop off /pick up load zone (no. of cars at the same time) Drop off /pick up load zone (no. of buses at the same time) WILL THE FACILITY RENTAL INCLUDE THE FOLLOWING

FACILITIES, EQUIPMENT OR SUPPLIES AT NO EXTRA CHARGE?

YES NO NOT AVAILABLE

IF NO, COSTS

PER DAY REMARKS

Number of training day(s) (please specify how many) Number of fit-out and decommissioning days (please specify how many) Access to the venues prior to fit-out days during non-exclusivity period Provide a clean venue with no advertising boards

All the rooms specified above All the outdoor field(s) / space(s) specified above Sport equipment (please specify in remarks column) Furniture, fixture and equipment (FF&E) (Please specify in remarks column) Electricity consumption Waste management Parking during the event Parking prior to the event

DO THE FACILITY RENTAL COSTS INCLUDE THE FOLLOWING SERVICES AT NO EXTRA CHARGE? YES NO

SERVICE NOT

AVAILABLE

IF NO, COSTS

PER HOUR

REMARKS (please specify in remarks if this service

has to be provided by the owner because of exclusivity clauses)

Janitorial services for existing room in building Janitorial services for outdoor field Field maintenance Plumbing services Electrician services Manpower services Telecommunication technician(s) Receptionist service Security personnel

Appendix I - Bidding community statement The bid committee represented by [organization name] _____________ and the bid institution represented by [organization name] ___________________agree to comply with the following statement: Cooperate fully with the Canadian Deaf Sports Association in the staging and hosting of the Event and assume responsibilities for all expenses concerning the 2016 Canada Deaf Games. Agree that all contents of the bid application submitted by the bid committee and the bid institution are binding, unless it is conflicts with the obligations listed in the Request for Proposal for the 2016 Canada Deaf Games. Any changes to the bid application once the event has been awarded must be approved by The Canadian Deaf Sports Association prior to taking effect. Immediately after being awarded the event by The Canadian Deaf Sports Association and no more than 30 days later, the Bid Committee and Bid Institution must create a Local Organizing Committee (LOC) which shall be responsible for the organization of the event. This LOC must be legally formed and be a non-profit organization. The Founding Members of the LOC must comprise one member from each of the following organizations:

• Canadian Deaf Sports Association • Provincial Deaf Sports Association(if applicable) • Bid committee • Bid institution

The appointment of the LOC is conditional upon the Organizing Committee undertaking in form and substance satisfactory to the Canadian Deaf Sports Association to fully comply with the terms and conditions of the obligations listed in the RFP. Both the Bid Committee and the Bid Institution shall be jointly and severally liable for all commitments entered into by them, individually or collectively, in connection with the organization and staging of the event, including any obligation under the RFP for the 2016 Canada Deaf Games. BID COMMITTEE BID INSTITUTION __________________________ _______________________ Organization Organization __________________________ _______________________ Name (print) Name (print) __________________________ _______________________ Position (print) Position (print) __________________________ _______________________ Signature Signature