PROXY BALLOT

Street Address

City, State, Zip

Phone Number

Your Custom Text Here

I, the undersigned, hereby acknowledge that I am a member in good standing with 100 Women Who Care Sea to Sky and that the person designated below has the authority to vote for me at the 100 Women Who Care Sea to Sky meeting on the date specified below.

Name of Designee

First Name

Last Name

Name of Absentee Voter

First Name

Last Name

I acknowledge that my designee may submit my vote as they wish. My designee and I both understand that this dated and signed ballot must be presented at the registration table WITH a cheque for $100 prior to the start of the meeting.

I agree

First Name

Last Name

Date of Meeting

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