MEMBER PROXY

MEMBER PROXY U.S. ARMY WARRANT OFFICERS ASSOCIATION
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
To ensure that we have a quorum for the meeting, please date and sign below, ADD your Membership Number, and return this PROXY. (Select one of the following two choices. If you select the first, fill in the name of the proxy-assignee)
I hereby appoint as my proxy

Name of proxy-assignee
Name of proxy-assignee
I hereby appoint my region director (or representative) as my proxy

I hereby appoint my region director (or representative) as my proxy,
with full power of substitution to act and vote on behalf of the undersigned as the undersigned would be entitled to vote if personally present at the USAWOA Annual Meeting of the Members, or at any adjournment thereof. This proxy is valid until superseded by the undersigned. If you appoint someone by name, BE SURE that the individual is a USAWOA member in good standing and attending the meeting; if not, your proxy is invalid. Please check one of the two options above, and sign and date this form, OTHERWISE THE PROXY IS INVALID
MEMBERSHIP NUMBER
Print Name Here
SignedDate Sign Name Here (Note: To email this you will need to print, sign & date, scan, and email it to director@usawoa.org. A fillable version of this document is available on the USAWOA Portal. A valid signature is required!)
Sign Name Here

Clear
USAWOA Form 500-10 (February 2024 (Once executed, this form may not be reproduced
Should be Empty:

MEMBER PROXY U.S. ARMY WARRANT OFFICERS ASSOCIATION