Proxy Request Form
I, ______________________, request the use of a proxy at the
Undergraduate Student Government General meeting on Sunday, __________________; at which I will have an excused absence from. The
proxy I have selected is in good academic and disciplinary standing, fulfils
the constitutional requirements of my position and has committed that
they will attend the meeting.
By signing this, I acknowledge that I bestow my right of opinion and right
to vote at said meeting onto this proxy member for the duration of said
meeting. This proxy has been briefed on my opinions pertaining to relevant
current USG issues, and is informed to speak for me. I understand that all
opinions and votes cast by this proxy are final, and reflect on my voting
record as well as in the minutes.
** The Vice President of Administrative Affairs will act as the notary for this
document, all parties must sign and date at the same time.
_____________________
________________________ __________
Council Member Name
Council Member Signature
_____________________
________________________ __________
Proxy Member Name
Proxy Member Signature
_____________________
________________________ __________
VP of Admin Affairs Name
VP of Admin Affairs Signature
Date
Date
Date