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, 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 29 May, 2025.

For Agenda Item 11, please only vote for one candidate.

Agenda Item*

	In favour	Against	Abstain
Item 3. Confirmation of the Draft Minutes of the previous Annual General Meeting for Neuromuscular WA held on Thursday 23 May 2024
Item 5. Chair and CEO Report
Item 6. Audited Financial Statements
Item 7. Appointment of Auditor for 2025 – HLB Mann Judd
Item 8. Special Resolution - Adopt the proposed amendments to the Constitution
Item 9. Honorary Life Membership nominations
Item 10. Election of Board Members

Member's Signature

Clear
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 27 May, 2025. As per rule 10 (15) no member may hold more than one proxy.

Any questions, please contact Operations & Engagement Manager, Emma Kenton, on 0417 090 583 or email info@neuromuscularwa.org.au
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