2024 - Z136 Annual Meeting Proxy Form

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Please respond to the below form by January 29, 2024. Please review all form questions before submitting. This meeting is held virtually via Zoom. Please ensure the proxy you assign is a voting member of ASC Z136, is planning to attend the meeting, and has accepted your request to hold a proxy for you.

Email *

Full Name *

VOTING MEMBERS ONLY (Proxy Designation): If you cannot attend the annual meeting in-person, please write the name of the Z136 member who has agreed to hold your proxy and will vote on your behalf on approved agenda items. Note that it is your responsibility to confirm that the individual will attend the meeting and hold your proxy. By recording their name below you are granting them permission to vote on behalf of you or the organization you are representing at the 2023 Z136 Annual Meeting.

SSC/TSC CHAIRS: If you cannot attend, please write the name of the person who will present your 15-minute subcommittee report.

If you would like to submit items for consideration to add to the agenda, please write them below: *

A copy of your responses will be emailed to the address you provided.

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