MHCF Proxy - Life Time Members

Dear Life Time Member of the Mt. Horeb Community Foundation,

This proxy designation is available to be signed by each Life Time member of MHCF in lieu of attending and voting at the Annual MHCF Meeting. Please have each Life Time member in your household submit a response so we can have a quorum (10% of our membership) at the meeting.

By electronically signing this proxy designation, you are granting the designated person listed in the proxy statement permission to vote on your behalf. Each of the persons listed in the proxy is a current Board member of MHCF. (This proxy shall be void if you personally attend said meeting.)

The annual meeting will be held on November 6th, 7pm, in the Mt. Horeb Community Center,  located at 107 N. Grove St., Mt. Horeb, WI 53572. (This proxy shall be void if you personally attend said meeting.)

Proxy Votes must be submitted by November 3rd in order to be processed ahead of the Annual Meeting.

Thank you, Mary Klopotic, MHCF Executive Director

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Email *
Your Name (considered your signature) *
Today's Date: *
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I hereby appoint this Board member to be my proxy and represent me and vote for me on all matters put before the membership at the upcoming MHCF Annual Meeting.  (If this Board member is unable to attend the meeting, their votes will be divided among the 4 officers.) *
I hereby appoint this Non-Board member to be my proxy and to represent me and vote for me on all matters put before the general membership at the upcoming MHCF Annual Meeting.  
Skip this question if you do not want a write-in candidate. If both questions are blank or not legible, or if the write-in candidate doesn't attend the meeting, the proxy vote will be divided among the 4 Officers.
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