Limited Proxy Form 2022
This is a limited proxy form that the individual submitting the form may use to designate a proxy to attend the Annual Meeting of the Chautauqua UCC Society, Inc. to be held at 1:00 P.M. on August 28, 2022 in Randell Chapel at Chautauqua. In order to be valid, this form needs to be submitted no later than 1:00 PM on Friday August 26, 2022.

The proxy holder named below has the authority to vote and act for the individual submitting the form to the same extent that individual would if personally present, with power of substitution, except that the proxy holder’s authority is limited as indicated below:

Sign in to Google to save your progress. Learn more
Email *
Name: *
Today's Date: *
MM
/
DD
/
YYYY
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy