KCNS Proxy Authorization Form

KCNS Proxy Authorization Form

AGM 2021
Please fill out this form if you are unable to attend the Annual General Meeting of KCNS for 2021 and would like your vote to be counted. We strongly recommend your participation and value your feedbacks and suggestions. Before sending this form, discuss your representation with your proxy. Proxy provisions are mentioned in Article VIII (3) section of our By-Laws.
Member Name*

First NameMiddle NameLast Name
Name of Proxy*

First NameMiddle NameLast Name
I, current member of Kansas City Nepalese Society, am unable to attend the Annual General Meeting being held on December 19th, 2021 via Zoom and would like to appoint proxy to participate and vote on my behalf.
Member Signature*

Clear
Proxy Signature*

Clear
If the meeting is rescheduled, use the consent below to use the proxy form for your attendance.*

I DO AgreeI DO NOT Agree
I authorize KCNS to use this form to meet the “in writing” requirement of proxy appointment. If you elect to disagree, your proxy can still attend the meeting but cannot vote on your behalf.*

I DO AgreeI DO NOT Agree
Should be Empty: