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Member Proxy Form
Submission Date
Member Name requesting Proxy
Member Email requesting Proxy
Use this proxy to establish a quorum only
Use this proxy to establish a quorum and let the board vote as a whole
Use this proxy to establish a quorum and assign a MBYC Member to vote
Do not enter a name below unless you selected
"Assign MBYC Member" above
I hereby assign as PROXY TO VOTE ON MY BEHALF the regular member I am entering here:
Member selected to be Proxy
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