Proxy voting form
Questions or alternate formats?
Contact 07764182966 or charter@adf.ie
If you cannot come to the Extraordinary General Meeting on 20th March 2014 you can still
vote at it, if you want to.
You do this by appointing someone to vote for you. This person is your proxy.
Your proxy can be the Chair of the meeting or another person you name in advance.
You can tell your proxy how to vote. Or you can let them decide.
If you cannot attend and want to vote you need to complete this form.
It must be back with us by 12 noon on Monday 17 March 2014 at the very latest.
You can post it or return it unsigned by email. We may contact you to verify it.
Your name
__________________________________________________
Your address
__________________________________________________
Your email
___________________________________________
Phone number
____________________________________________
I am a member of ADF (a disabled or deaf person who supports the organisation’s aims and
is a signed up member for 2014)
I want to appoint a proxy to vote in my name and on my behalf at the Extraordinary General
Meeting of the Arts & Disability Forum to be held 2.00pm Thursday 20th March 2014 in 109
– 111 Royal Avenue, Belfast, BT1 1FF.
Pick one of the below. Cross out or delete the line you do not want.
I appoint the Chair of the meeting as my proxy
OR
I appoint the person below as my proxy
Name ____________________________
Or if they are unable to attend, the person below shall be my proxy
Name ___________________________ (this can be the Chair of the meeting if you wish)
Signed ___________________________________ sign your name here
To tell your proxy how to vote in some or all of the votes, please turn over.
Proxy voting information and form
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If you do not complete this section, or parts of it, it is assumed that you want your
proxy to vote in your name in all matters as they see fit.
1 The Special Resolution– That the members approve the proposals put forward by the
Board in the paper ‘Proposed Amended ADF Constitution 2014’ and instruct that the
governing document be amended accordingly.
The Board supports this and asks you to vote FOR the Resolution
Pick one by crossing out the others so only the one you want is left.
For
Against
Abstain (not voting)
My proxy can chose
2 Any other resolution being made from the floor on the day
Pick one by crossing out the others so only the one you want is left.
For
Abstain (not voting)
My proxy can chose or
In these instances alone my proxy shall vote to support the Chair of the meeting
Signed ___________________________________ sign your name here
Return by email or post please to
charter@adf.ie or
‘EGM Secretariat’ ADF. 109 Royal Avenue, Belfast, BT1 1FF
To arrive no later than 12pm Monday 17th March 2014
If you would like information in an alternative format, please
contact charter@adf.ie or text or call 07764 182 966
Proxy voting information and form
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