8th PeMSAA Australasia Conference - 2024 Perth Save the dates: 17-18th Aug 2024
Appointment of Proxy Form
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I, (name in full, required) of address (required)
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being a life member of the Peradeniya Medical School Alumni Association- Australasia hereby appoint;
Full name of proxy (required) of address (required)
being a life member of that Peradeniya Medical School Alumni Association- Australasia, as my proxy to vote for me on my behalf in all matters arising at the event outlined above.
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Signature (Text/ Required) By signing, I nominate the proxy to act on my behalf at the above event
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