Please use this form if you are unable to attend the AGM

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* 1. My details and contact Information

I am aware that the members below are standing executive team members and each would like to  would like to stand for re-election to their positions.

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* 2. My Vote is as follows:

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* 3. I confirm that I am UNABLE to attend the 2022 RKCC AGM AND proxy is
required to confirm on my behalf.

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* 4. PROXY - In addition to my voting preference above, I hereby authorise current RKCC financial member named below to vote on all other matters as a proxy on my behalf.  Please note this must be a financial member of RKCC, and
cannot include operational employees such as  RKCC CEO, Events Manager or Membership Officer.

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* 5. I understand ticking the box below is my form of electronic signature

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* 6. Submitted on

Date

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* 7. Office Use only - Signature of Proxy is required

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