Z136 RSVP and Proxy Form

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Please respond to the below form by February 10, 2023. Please review all form questions before submitting. This meeting is held in conjunction with the International Laser Safety Conference (ILSC). For more information about ILSC or to take advantage of the hotel group rate, visit: https://ilsc.ngo/attend

Email *

Full Name *

RSVP: Do you plan to attend the Z136 Annual Meeting, held in Portland, OR on February 26, 2023 at the Hyatt Regency Portland? *

Yes

ATTENDEES: Please indicate if you are attending the meeting as a voting member of Z136 or as an observer. Note that being a member of a Z136 subcommittee (e.g., SSC-1) does not automatically make you a member of the Z136 Committee (main consensus body). If you are unsure if you are a member of the Z136 Committee, check the current roster at: https://z136.lia.org/committees/oversight-committee/z136-standards-committee

Z136 Member (can vote)

Observer (non-member, cannot vote but can make comments)

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ATTENDEES: Please Note any dietary restrictions below, as lunch will be catered by the hotel for meeting attendees.

Vegetarian

Vegan

Gluten-free

None

Other:

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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