The Membership Administrators at the Black Lawyers Association Have Setup a Membership

PROXY FORM 2016

I, undersigned ______

Identity number: ______

Being a member of the Black Lawyers Association in good standing.

Practicing in the province of: ______

Hereby appoint______

IDENTITY NUMBER______

Being a member of Black Lawyers Association, in good standing, as my proxy to vote for me in my name at the Annual General Meeting of Gauteng province, to be held Saturday 07th day of May 2016 in Johannesburg, Gauteng Province. The proxy is authorized as, He / She may deem fit, to vote on my behalf in relation to the new office bearers or on any motion that may be put forward.

I attach a certified copy of my identity document.

Signed at: ______

Signature: member in good standing ______

APPROVED by: ______

Signature: Branch chairperson/ Treasurer

______

Signature: Branch chairperson / Treasurer