BRISBANE CATHOLIC BUSHWALKING CLUB

PO Box 31, Red Hill Q 4059

(Incorporated under the Associations Incorporations Act, 1981)

APPOINTMENT OF PROXY

(This form must be in the hands of the Authorised Person prior to the commencement of the Meeting)

I,

____________________________________________________

(Full Name)

of

____________________________________________________

(Residential Address)

being a Financial Member of the Brisbane Catholic Bushwalking Club

(hereafter “The Club”)

hereby appoint

_________________________________________

(Full Name)

of

____________________________________________________

(Residential Address)

whose signature appears below, and is a Financial Member of The Club, my Proxy to vote for me on my behalf at the

_____________________

(Type of Meeting)

meeting of The Club, to be held on day of

____________ _________ _____

(Day) (Month) (Year)

and at any adjournment thereof.

______________________________ / /

(Signature of Appointor) (Date)

I, being a Financial Member

____________________________________

of The Club, hereby agree to act as a Proxy for the above named member.

____________________________________ / /

(Signature of Appointee) (Date)