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* 1. Please enter your full name

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* 2. Please confirm you are a current member of ANZEA

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* 4. Please name the proxy you are appointing
If you do not include a member's name/leave this blank, by default this will the Convenor/Chair.

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* 5. Do you authorise the proxy to vote on your behalf at the Special General Meeting being held on 27 March 2026?

T