Queensie AGM Proxy Nomination Form – Queenscliff Surf Life Saving Club

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QSLSC AGM Proxy Vote Authorisation

Please accept my apology (Financial member Name)*
First Last
For non-attendance at the Queenscliff Surf Life Saving Club Annual General Meeting at 2.30pm on Sunday, 17th August 2025. Please ensure you nominate a Financial Member of Queenscliff SLSC. I nominate as a Financial Member of Queenscliff Surf Life Saving Club as my Proxy to vote on my behalf:*
I agree
For non-attendance at the Queenscliff Surf Life Saving Club Annual General Meeting at 2.30pm on Sunday, 17th August 2025.

Please ensure you nominate a Financial Member of Queenscliff SLSC.

I nominate as a Financial Member of Queenscliff Surf Life Saving Club as my Proxy to vote on my behalf:
Name of Proxy*
First Last
Date