PROXY FORM

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PROXY FORM

Please fill out the information below if you, as the President of your Local are designating another Local to vote on your behalf at the 2022 Burn Fund AGM. Please include name and contact information below.

Thank you,

Jeff Sauvé
Executive Director

Your Local Affiliate (Unable to Attend AGM) *

PROVIDE THE LOCAL, NAME OF MEMBER, TITLE AND EMAIL OF THE LOCAL CARRYING YOUR PROXY.

The Local to Carry our Proxy Vote *

Your Proxy Vote's Full Name *

Your Proxy Vote's Email *

Your Proxy Vote's Title *

Submit

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