HomeProxy Nomination

Proxy Nomination

Please enable JavaScript in your browser to complete this form.

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Nominate

Nominee Email

I, being a member of the GIAV, appoint the above nominee to vote on my behalf this year at the AGM of the Association

behalf of of

Date / Time

Date

Time