Proxy for 2024 Annual Meeting - National Amateur Retriever Club

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Member Club *

Title of Person Filling out this Form (Club President, Secretary, etc) *

Name of Person Filling out this Form *

Email Address of Person Filling out this Form *

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Proxy's Name *

Proxy's Email *

Proxy's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Agreement *

I confirm that the proxy I have listed may act on behalf of my club.

By way of this proxy, I grant permission to the individual listed in the "Proxy's Name" field to be my club's lawful attorney and to serve as proxy in its name at the Annual Meeting of the Member Clubs to be held at the National Amateur Championship and any adjourned meeting thereof upon amendments to the By-Laws of said club and upon any and all other matters that may come before said meeting.

Absent Proxy

I authorize the National Amateur Retriever Club President or the National Amateur Retriever Club Secretary/Treasurer to appoint an alternate with full power to act in the stead of said above-named proxy if the above proxy is not available..

Additional Comments