Fill out the form below and submit online. Name of club proxy is appointed to *The Class A Voting Member Club appoints the following proxy who has been apprised of the member clubs directions on agenda items.Date of Members MeetingDate of members meeting for which the proxy is actingProxy NameThis proxy is authorized to vote on behalf of the above mentioned clubEmail AddressPhoneProxy is a member of:Give the name of the club which the proxy is a member (must be a Class A voting club)DateDate signedPosition held in the clubPositionPresidentVice PresidentSecretaryName of Club OfficerI have authority to appoint a proxy on behalf of the above named clubEmail Address of Club Officer Send Proxy Form
