Proxy Form

Proxy Form

This will allow your representative to vote on the relevant matters at the AGM on your behalf.
To: SafeCare BC Health and Safety Association (the "Association")

The undersigned, being a corporate member of the Society, hereby appoints
First Name of Your Representative* Last Name of Your Representative*as its representative to attend at and, if the corporate member is a voting member, vote at all general meetings of the Association for 2025 or until such time as this appointment is revoked in writing by the undersigned.
Signed this day of

MonthDayYear
Date
Name of Corporate Member

My First NameMy Last Name
Title / Position
For example: Executive Director
Name of Organization
For example: ABC Care Home
Should be Empty: