Proxy form – SGM 5th December 2016

I (name)

of (postal address)

email address


being a member of Clayton-le-Moors Harriers do hereby appoint (name of proxy)

to vote on my behalf at the Special General Meeting of members of Clayton-le-Moors Harriers which will be held at The Woodman Inn, Burnley on Monday 5th December 2016 at 19:00.


  • Appointment of a proxy does not preclude you from attending the meeting and voting in person. If you have appointed a proxy and attend the meeting in person, your proxy appointment will automatically be terminated.
  • Members granting proxy must be eligible to vote at the SGM.
  • Members holding proxy must be eligible to vote at the SGM.
  • All proxy votes held by a member and that member’s own vote must be cast in the same direction, or not cast at all.
  • Proxy forms must be received by the Secretary before 19:00 on Friday 2nd of December 2016.