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

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* 1. My details and contact Information

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* 2. I confirm that I am UNABLE to attend the RKCC AGM AND this proxy is
required to notify a record of my absence, and my intentions.

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* 3. There are a maximum of 7 positions available for election. In your absence, please use this proxy form to select your 7 preferred nominees from the list below.

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* 4. PROXY - 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, or Administration team, unless they are members in their own right.

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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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