Line Dance Association
Of Australia

APPOINTMENT OF PROXY

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SECTION 1

I,......................................................................................................No...............................

(full name)

of:......................................................................................................................................

(address)

being a member of L.D.A.A. Line Dance Association of Australia Inc. hereby appoint

(q The Chair Person).............................................................................................................

(full name of proxy or tick Chairperson of the Meeting)

 

of ..................................................................................................................................................

(address of proxy if not Chairman)

being a member of L.D.A.A. Line Dance Association of Australia Inc., as my proxy for the Annual General Meeting of L.D.A.A. Line Dance Association of Australia Inc.

will be held at:.Tamworth Tennis Club, Treloar Park, Napier Street, Tamworth

on Saturday, 26nd January, 2002

commencing at:12.30pm

and at any adjournment of that meeting.

SECTION 2

Signed : ..................................................................................................................................................

(Signature of member appointing proxy)

Forward to:

The Committee

L.D.A.A. Line Dance Association of Australia

PO Box 1124

Baulkham Hills NSW 1755

Fax: 02 9981 2778

Date:

(Proxy notice to be must be received prior to the meeting)

 

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Last modified: 27 July 2003