Leaders Institute of South Australia November 2017 Special General Meeting

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* 1. Please advise your name and email address

Name

Email address

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* 2. Will you be attending the Special General Meeting on November 29, 2017 at 5pm

Yes - thank you for letting us know, we look forward to seeing you there.

No

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* 3. If you are unable to attend, please nominate a Proxy to vote on your behalf so that we can reach the numbers required to hold the Special General Meeting.

I nominate the Treasurer of the Leaders Institute of South Australia to vote on my behalf

Alternatively, I nominate the following voting Member of the Association to be my proxy (pls include their email address)

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* 4. Proxy instructions : Proposed special resolutions to alter the Leaders Institute Constitution

I vote for the proposed changes to the Constitution

I vote against the proposed changes to the Constitution

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* 5. If your proxy does not attend the meeting or is ineligible to be your proxy, do you agree that the Chair of the Special General Meeting can act as your proxy.

Yes