Your Name (required):

Your Email (required):

Your Membership Number (if known):

1. Attendance

Will you attend the Annual General Meeting on 26th September 2026?

Yes, I will attendNo, I will not attend

2. Appointment of Proxy

Complete this section only if you are NOT attending and wish to appoint a proxy. Your proxy must also be an IAI member.

I appoint the following person as my proxy:

Proxy's Membership Number (if known):

If my proxy is unavailable, I appoint the Chairperson of the meeting as my proxy. (If you do NOT want this, please check the box below)

I do NOT want the Chairperson to act as my proxy if my named proxy is unavailable

My proxy is authorised to vote on my behalf at the IAI AGM 2026 (and any adjournments).

Directions on voting (e.g., on election - if you want to specify):

3. Council Membership Nomination

I do NOMINATE MYSELF for the membership of the SUPREME COUNCIL - Write Your Name in the box below:

I volunteer my service for the following divisions (required): ICWAIMAWAPLSWA

4. Your Signature

By typing your name below, you agree that this constitutes your electronic signature.

Date (required)