Instrument of Proxy
For BirdLife Melbourne AGM 25March 2014
[NB: If you propose to attend and vote at the AGM you are not required to return this form]
I,…………………………………………..………of………………………………………………………..
……………………………………………………………………………………………………….…………
being a financial member of BirdLife Australia, a member of BirdLife MelbourneBranch and entitled to
vote hereby appoint………………………………………..…………, or in their absence the Chair of the
Meeting,as my proxy to attend and vote for me at the BirdLife Melbourne Annual General Meeting to be held at the Balwyn Evergreen Centre, 45 Talbot Avenue, Balwyn, on Tuesday 25March 2014, commencing at 8:00 pm,and at any adjournment thereof in respect of theagenda item as set out herein.
Agenda Item 4
That the following nominations for Committee Members are elected.
Please name your choice of five maximum of the nominations received. A maximum of five of the nominations, listed on the BirdLife Melbourne Website by, 3March 2014, may be included on the list below.
- ………………………………………………………….………………………………………
- ………………………………………………………………………………………………….
- ………………………………………………………………………………………………….
- . ………………………………………………………………………………………………...
- ……………………………………………………………………………………………….…
If less than five nominations are named, the appointed proxy shall make the choice for the remaining number.
Signature:……………………………………………..…………Date:…………………………..
Notes
1An Instrument of Proxy must be in writing signed by the appointer or by his/her attorney.
2To be effective, the Instrument of Proxy must be returned or mailed toAlan Crawford, BirdLife Melbourne Secretary, c/- BirdLife Australia, Suite 2 - 05, 60 Leicester St, Carlton, Vic 3053, to be received by 5:00 pm, 20March 2014. A scanned copy of a signed Instrument of Proxy emailed to by 5:00 pm, 20March 2014 will also be accepted.
3If you wish the person acting as your proxy to exercise his/her discretion at the meeting, you do not need to name the Committee Members you wish to be elected,
4An Instrument of Proxy returned without the insertion of the name of the proxy may be exercised by the Chair of the meeting.
5This Instrument of Proxy is similar to an absentee ballot.
Note: To be a valid vote, this Instrument of Proxy must include as a minimum your name, your address, and your dated signature.