AGM Paper Submission – Queensland Branch

My Details

Details will be used to confirm eligibility to vote and to keep your contact details up to date

Last Name *

Given Names *

Telephone Number

Email Address

Address

Address Line 1 *

Address Line 2

City

State *

Post Code *

Country

Attendance

I am planning to attend the AGM at RUSI Building, Victoria Barracks, Petrie Terrace, Brisbane on 29 September 2023. Please warn me in for security. I am aware I have to bring proof of identity, eg Driver’s Licence *

Yes

Apologies and Proxy

I am unable to attend. I nominate the following as my Proxy / Alternate Proxy to vote on my behalf at the DFWAQ AGM on 29 September 2021, and at any resumption after adjournment thereof.

Name of Proxy

Name of Alternate Proxy (if applicable)

Alternatively, I give my Proxy to the Chair of the meeting

Check this box to nominate the Chair as my Proxy

Committee Nominations

I nominate the following members (as applicable) to the committee. I acknowledge that those I nominate must accept the nomination before any vote.

Nomination for President of DFWAQ

Nomination for Vice-President of DFWAQ

Nomination for Treasurer of DFWAQ

Nomination for Secretary of DFWAQ

Volunteering

If you would like to volunteer with DFWAQ, please let us know what your interest areas are. More information is available at qld.dfwa.org.au/volunteer

Please contact me about volunteering opportunities. *

Yes

Volunteering Areas of Interest