AGM Proxy Form

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AGM Proxy Form

A member who is unable to attend the AGM may be able to delegate their voting power to another member or representative to vote in their absence. That person is known as a 'proxy'.

Email *

Your First and Last Name *

I am a voting member of the Halton-Peel Community Aphasia Programs (H-PCAP) and am in good standing. *

Yes

I give my proxy to the individual named below (registered proxy) so that they may vote on my behalf on all matters which may arise at the H-PCAP Annual Membership Meeting to be held at 7:00 p.m. on Wednesday, September 29, 2021. Please include full name of registered proxy here: *

Today's date *

YYYY

PLEASE NOTE: The registered proxy is the only person eligible to vote, amend or second motions. To be valid a signed proxy must be delivered to the Secretary by 5:00 pm on Monday, September 27, 2021. A proxy may be delivered electronically to info@h-pcap.com *

Yes, I understand

Other:

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