2019 USTA Central Indiana Proxy

2019 USTA Central Indiana Proxy
Please cast your Membership vote by checking one of the following boxes:*

IndividualA designated member of USTA Central IndianaAbstain from voting
Individual/USTA Central Indiana representative name *
Title of Organization or Title (please list all Organizational/Past President/Board of Directors votes you will be representing)*
Please find below the 2020 Nominations
By way of this proxy, I officially appoint the above as my proxy. I give my proxy the authority to vote on my behalf at the USTA Central Indiana Annual Meeting, November 9, 2019. The proxy shall have full power to vote any issue, motion or action at the meeting.
Signature*

Clear
Name*

First NameLast Name
Email*
example@example.com
Date

MonthDayYear
Date
This proxy must be submitted by 5 p.m. local time, Friday, November 1, 2019

All legally sufficient proxies submitted to the Secretary will be accepted.
Should be Empty: