CHAPEL STREET PRECINCT ASSOCIATION - APPOINTMENT OF PROXY FORM
CSPA ANNUAL GENERAL MEETING - DATE TBC [WEDNESDAY 21 NOVEMBER AGM WAS DEFERRED]

Important - Please note, this form can only be filled out by your business's CSPA representative.

For extra clarification, fill out this form if you cannot attend the AGM, but would like to nominate a proxy (from another CSPA business) to attend and vote on your behalf.

Email address *
Please follow the questions to lodge your official appointment of proxy:
Your Full Name (and Business Title) *
Your answer
Address *
Your answer
Insert Below Your Full Chapel Precinct Business Name & Address *
Your answer
Being a member of Chapel Street Precinct Association Inc. I wish to nominate the person named below to vote for me (on my behalf) at the CSPA Annual General Meeting [date TBC]: *
Your answer
RATIFICATION
Please state your proxy's Business (and Business Address): *
Your answer
Proxy Phone Contact *
Your answer
Please tick the box (below) to indicate that the above member is aware of their appointment of proxy. The CSPA will contact them to confirm this. *
Required
Please type your initials below to ratify this appointment of proxy: *
Your answer
*
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Time
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Please contact Chrissie Maus [CSPA General Manager] should you have any questions around the appointment of a proxy - cmaus@chapelstreet.com.au http://www.chapelstreet.com.au/members/
A copy of your responses will be emailed to the address you provided.
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