Meeting:2013 SGM/Proxy form

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Form of Appointment of Proxy.

I,

(name)

of

(address)

being a member of Wikimedia Australia Inc.


appoint

(name or role of proxy holder)[1]


also being a member of that Incorporated Association, as my proxy to vote on my behalf at the Special General Meeting of the Association to be held on Sunday 20 October 2013 and at any adjournment of that meeting.


Either:

My proxy is authorised to act on their own discretion.

Or:

My proxy is authorised to vote as specified for the following resolution(s):




Signed


Date


  1. You may nominate a member by name or by role (for example, the chair or the secretary etc).

Note: A proxy vote may only be given to a person who, at the time of the meeting, is a current financial member of Wikimedia Australia.