Annual general meeting




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AUSTRALIAN DENTAL ASSOCIATION (QUEENSLAND BRANCH)

ABN 98 138 331 174

and

AUSTRALIAN DENTAL ASSOCIATION (QUEENSLAND BRANCH)

Union of Employers

ABN 56 009 663 754
ANNUAL GENERAL MEETING

PROXY FORM
I……………………………………………………………………………………………………………
of………………………………….……………………………………………………………………….
being a financial member tender my apology and hereby appoint
□ the Chairman of the Meeting to act as my proxy,
or
□ Name: …………………….……………………………………………………………………
Address: ………………….……………………………………………………………………
or, failing attendance of the appointed person above, the Chairman of the Meeting as my proxy to attend and vote at the relevant Annual General Meeting to be held on Friday, 28 November 2014 and at any adjournment thereof and to vote in accordance with the following directions or, if no directions have been given, to vote as my proxy thinks fit or to abstain from voting.
Directions to proxy: ……………………..………………………………………………………………

……………………………………………………………….…………………………………………….

……………………………………………………………….…………………………………………….

……………………………………………………………….…………………………………………….

……………………………………………………………….…………………………………………….

Signed ………….……………………………………….this………….day of…..………………2014




NOTE:

  1. All Active and Life Members of the Association are eligible to vote at the Annual General Meeting of the Australian Dental Association (Queensland Branch).

  2. A proxy for the Annual General Meeting of the Australian Dental Association (Queensland Branch) must contain the full names of both the Member and their proxy (if other than the Chairman) and is to be signed and dated by the Member.

  3. Only Employer Members are eligible to vote at the Annual General Meeting of the Australian Dental Association (Queensland Branch) Union of Employers.

  4. A proxy for the Annual General Meeting of the Australian Dental Association (Queensland Branch) Union of Employers must contain the full names of both the employer Member and their proxy who must also be an Employer Member (if other than the Chairman) and is to be signed and dated by the Employer Member.

  5. Proxy forms must be received by the CEO ADAQ PO Box 611 Albion 4010 by post or facsimile to 07 3252 4488 by 3.00pm Wednesday, 26 November 2014.


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