2023 RKCC ANNUAL GENERAL MEETING (AGM) - 4 October 2023 Proxy

Please use this form if you are unable to attend the AGM

Question Title

* 1. My details and contact Information

First Name

Last Name

Company

Email Address

Phone Number

Question Title

* 2. I confirm that I am UNABLE to attend the 2023 RKCC AGM AND a proxy is
required to confirm on my behalf.

I would like to allocate a current RKCC financial member as a proxy and I have confirmed that this person will be in attendance at the meeting

Question Title

* 3. I hereby authorise current RKCC financial member named below to vote on all other matters as a proxy on my behalf. Please note this must be a financial member of RKCC for at least 6 months prior to the AGM, and cannot include operational employees such as RKCC CEO, Events Manager or Membership Officer.

PROXY First Name

PROXY Last Name

Question Title

* 4. I understand ticking the box below is my form of electronic signature

Yes

Question Title

* 5. Submitted on

Date / Time

Date

Question Title

* 6. Office Use only - Signature of Proxy is required