Tamborine Mountain Landcare

10/15 Main Street, North Tamborine 4272

Proxy Form

I, ……………………………………… of ……………………………………..

being a member of the Association

appoint …………………………………of ……………………………………..

as my proxy to vote for me on my behalf at the Annual General Meeting of the

Association to be held on the ………day of …………………. 20 …..

And at any adjournment of the meeting.

Signed this ……………..day of …………………… 20 …..

…………………………………..

Signature

This form is to be used

*in favour of

the resolution

*against

*Strike out whichever is not wanted.

(Unless otherwise instructed, the proxy may vote as the proxy considers appropriate)