Proxy Voting Form for the Association for Real Change Annual
General Meeting 2013
“I ........................................................................... being the Nominated
Representative of
…………………………………………………………………………………
(organisation name)
which is a FULL MEMBER of the Charity hereby appoint
......................................................................................................of
................................................................................................................
(organisation name)
to vote for me and on my behalf at the (Annual or Adjourned, as the case may be,)
General Meeting of the Charity to be held on the 3rd day of October 2013 and at any
adjournment thereof.
As witness my hand this ........................... day of ....................... 2013.”