Appointment of Proxy Form with name field

Appointment of Proxy Form

SECNA AGM 2022
Name*

First NameLast Name
Organisation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
As an Industry member of the Social Enterprise Council of NSW & ACT, I appoint [insert full name here]* to vote for me on my behalf at the Annual General Meeting of SECNA to be held on Friday 1 April 2022 and at any adjournment of that meeting.
I authorise my proxy to vote on my behalf:*

at their discretion in respect to any motion, orvote Yes/No in relation to the special resolution to make changes to the SECNA Constitution as outlined in the Special Resolution in the above section.
Signature*

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