Appointment of Proxy

Appointment of Proxy
In accordance with Rule 10 (13) of the Constitution of Neuromuscular WA, I:

Member's First NameMember's Last Name
of Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Being a member of Neuromuscular WA, I appoint:

Proxy's First NameProxy's Last Name
as my proxy.

My proxy is authorised to vote on my behalf at the Annual General Meeting (and any adjournments of the meeting) on Thursday 21 May, 2026.

Agenda Item*

Rows	In favour	Against	Abstain
Item 3. Confirmation of the Draft Minutes of the previous Annual General Meeting for Neuromuscular WA held on Thursday 29 May 2025
Item 5. Chair and CEO Report
Item 6. Audited Financial Statements
Item 7. Appointment of Auditor for 2026 – HLB Mann Judd
Item 9. Honorary Life Membership nominations
Item 10. Election of Board Members

Member's Signature
Date

MonthDayYear
Date
PLEASE NOTE:

Under the term of Rule 10 (14) of the Constitution of the Association, you must complete and submit this form to formalise your proxy by no later than 5.00pm on Tuesday 19 May, 2026. As per rule 10 (15) no member may hold more than five proxies.

Any questions, please contact CEO, Hayley Lethlean, on 0431 872 274 or email ceo@neuromuscularwa.org.au
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