SIA AGM Apologies and Proxies

NOTIFICATION OF APOLOGY AND/OR ASSIGNMENT OF PROXY
Please use this form to record an Apology and/or to assign a Proxy. Note that no member may hold more than five proxies. The member holding the proxies is also required to be financially up to date.
Full Name*

First NameLast Name
E-Mail*
SIA Member Number*
Phone Number:
By lodging this online form, I confirm that I am a member of the Submarine Institute of Australia Inc and that my membership is fully paid until the date shown below.
Membership Validity*

DayMonthYear
Please select all that apply:*

ApologyNote a proxy
I assign my Proxy to

First NameLast Name
Proxy e-mail address
a member of the Submarine Institute of Australia Inc as my proxy to vote for me on my behalf at the general meeting of the Association (Annual General Meeting or other General Meeting, as the case may be) to be held on Tuesday 16 November 2021 and at any adjournment of that meeting.
My proxy is authorised to vote

in favour ofagainstat his/her discretion in respect of
the resolution(s):
or any resolution

Yes
Notes:

1. Any person may only hold a maximum of five proxies.

2. A proxy may not be given to a person who is not a member of the Association or whose membership subscriptions are not paid up to date.
Should be Empty:

NOTIFICATION OF APOLOGY AND/OR ASSIGNMENT OF PROXY