Proxy voting form
To register your proxy, please print and complete this form and return it by fax to +61-7-3858-3199 before 9AM AEST (UTC+10) on Tuesday, 3 September 2002.
Note: Your APNIC Membership must be current on the day of the meeting, in order for your proxy to have effect.
I/We ___________________________________________________________
(person's name)
of _____________________________________________________________
(company name)
being a member of APNIC with _______________ votes
HEREBY APPOINT _________________________________________________
(person's name)
of _____________________________________________________________
(company name)
or failing him/her
________________________________________________________________
(person's name)
of _____________________________________________________________
(company name)
to be my/our proxy to vote for me/us at the Address Council election
to be held on Thursday 5 September 2002 and at the meeting of members
to be held on Friday 6 September 2002 and at any adjournment thereof.
________________________________________________________________
(Any restrictions on voting to be inserted here)
Signed this _____________ day of ____________________ _________
(day) (month) (yr)
________________________________________________________________
(member's account name - eg "ABCNET-AP")
________________________________________________________________
(member's signature)
________________________________________________________________
(member's contact phone number)
________________________________________________________________
(member's contact facsimile number)
________________________________________________________________
(member's contact email address)
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