Your Name *

First Name

Last Name

Certification *

I (as named above), being a member of the Inverloch Tourism Association appoint the person (named below), being a member of Inverloch Tourism Association as my proxy to vote for me on my behalf at the Annual General Meeting of Inverloch Tourism Association. to be held on 28th October 2025 and at any adjournment of that meeting.

I authorise my proxy to vote on my behalf: at their discretion in respect of any motion

Proxys Name *

First Name

Last Name

Digital Signature *

By ticking yes I confirm that I am the person named in section 'Your Name' and am assigning my vote to the person named in section 'Proxys Name'

Yes

Date Signed *

MM

DD

YYYY