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IGLYO 2022 Annual Members Conference - Proxy Nomination form

Both organisations must have agreed on the proxy before submitting the form. Please complete it before October 7th, 2022.

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* 1. The organisation granting the proxy vote

Organisation Name

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* 2. Organisation Address

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* 3. Legal Representative Name

Name of a legal representative from the member organisation who is delegating their vote by proxy

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* 4. Role in Organisation

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* 5. Legal Representative Phone Number

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* 6. Legal Representative Email

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* 7. Proxy Organisation Name

Please name the organisation you wish to delegate your vote by proxy to

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* 8. Name of the Official Delegate to be present at the Annual Members Conference

Please name the Official Delegate you wish to delegate your vote by proxy to

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* 9. By submitting this form, both the legal representative of the delegating organisation and the delegate of the receiving organisation acknowledge that the full vote of the delegating organisation will be held by the delegate of the receiving organisation voting items on the ageda will, among others, include:

Member organisations are advised to discuss of their votes in advance.

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