NGB Proxy 2018

USA Powerlifting National Governing Board (NGB) 2021 Voter Proxy/Assignment of Second Voting Rep Form

Deadline: June 14 at 5pm Eastern.
ONE FORM PER PROXY/VOTE
Name *

First Name Last Name
Position Held *

Athlete Representative Committee Chair Executive Committee State Chair 2020 2nd Voting Rep (TX, CA, NY, WI, FL)
E-mail *
STATE
COMMITTEE
2nd VOTING REP
I, as the holder of the position indicated above, wish to designate the following as the proxy for the NGB Meeting.
NGB Proxy Name *
*The proxy for a State Chair must be a USA Powerlifting member registered for the current year from that state. See USA Powerlifting By-Laws Sec 3.5 for all other conditions.
NGB Member Signature *
After you sign and submit the form, you will forward your email to the proxy to sign and submit.
Proxy Member Signature
Should be Empty:

USA Powerlifting National Governing Board (NGB) 2021 Voter Proxy/Assignment of Second Voting Rep Form