FORM OF APPOINTMENT BY PROXY

I (full name)……………………………………………of

(address)……………………………………………………………………………….

……………………………………………………..   being a financial full member of the Australian Screen Editors Guild Inc. hereby appoint (full name of proxy)

………………………………………………………………………….

being also a financial full member of Australian Screen Editors Guild , as my proxy to vote for me on my behalf at the Annual General Meeting of the Association to be held on 21st November, 2015 and at any adjournment of that meeting.

Signature………………………………………

Date……………………………………………

Send your completed Nomination and/or Proxy form to:

The Returning Officer

Australian Screen Editors Guild

PO Box 150, Paddington, NSW. 2021

Email: office@screeneditors.com.au

Proxy forms and postal votes must be received no later than 17th November, 2015

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