2022 National AGM - Proxy Form

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Full Name: *

Membership Number: *

As included in your email about the AGM

I, Being a current financial member of the Australian Fabians (2022) do hereby constitute and appoint: *

Write the full name of the person you are seeking to hold your proxy.

I note: *

The person selected above, is also a current financial member of the Australian Fabians, as my proxy at the National Annual General meeting of the Australian Fabians on 27th of July , 2019 in Canberra, or any continuation or adjournment thereof, with full power to vote and act for me and in my name, place and stead, in the same manner, to the same extent and with the same effect that I might were I personally present, giving to them full power of substitution and revocation, and I hereby revoke any other proxy heretofore given by me.

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By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *

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