AGM – Statewide Forum 2023

Please Select whether you are nominating a delegate or a proxy *

Appoint a Delegate from your shed that will be attending in person
Appoint a Proxy to Vote on your behalf

We hereby appoint as our voting Delegate that will also attend the Statewide Forum and AGM in person at "The Meadows" *

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This years AGM is combined with a Statewide Forum and will be held in person at the Meadows on October 16th commencing at 10.00am, arrivals accepted from 9.30am

We hereby appoint as our second Delegate (NON Voting) that will also attend the Statewide Forum and AGM in person at "The Meadows" *

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This years AGM is combined with a Statewide Forum and will be held in person at the Meadows on October 10th commencing at 10.00am, arrivals accepted from 9.30am

We hereby appoint as our third Delegate (NON Voting) that will also attend the Statewide Forum and AGM in person at "The Meadows" (copy) *

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This years AGM is combined with a Statewide Forum and will be held in person at the Meadows on October 10th commencing at 10.00am, arrivals accepted from 9.30am

Are you travelling from further than 100km from the the event location The Meadows? *

No
Yes

Are you applying for financial travel assistance of $100 if further than 100km? *

No
Yes

Name of the Person that is assigned your proxy vote *

The Shed your Proxy belongs to *

Your Proxy's Email Address *

Delegate's or Proxy Email Address *

Delegate's (Voting) Phone Number

2nd Delegate's (NON Voting) Phone Number

3rd Delegate's (NON Voting) Phone Number

Proxy's Phone Number

Shed Name of Nominator *

Name of Person Nominating *

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We nominate our delegate named above as authorised to attend and vote on our behalf at the Victorian Men’s Shed Association 2022 AGM

Nominator Phone Number

Position of Nominator at Shed (Dropdown List) *

Online Registration to attend

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