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Appointment of Proxy Form
Fusion Political Party - Annual General Meeting 2022
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Email
*
Your email
Full Name
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Please provide your full name that matches the provided email address as recorded in the Fusion member register.
Your answer
I, as a member of Fusion Political Party, appoint the following member as my proxy to vote on my behalf at the Annual General Meeting of Fusion Political Party to be held on 23 October, 2022 and at any adjournment of that meeting:
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Your answer
I confirm that the member knows I am appointing them as my proxy.
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Yes
Required
Important Information
Please note that proxy appointments must be received by the Fusion Political Party Secretary at least 24 hours before the time of the meeting.
Each member can hold a maximum of 5 proxies. Please ensure you have coordinated with your appointed member prior to completing this form.
The name and email address of each form will be verified against the Fusion Political Party member register for validity before the appointment is accepted.
A copy of your responses will be emailed to the address you provided.
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