May 9, 2008

Designation of Proxy 

If a delegate to the Alumni Council is unable to attend, this form must be returned with the name of the proxy and the signature of the delegate authorizing this action.

I __________________________ hereby authorize _____________________________
   Print Delegate Name                                  Print Proxy Name

to represent me at the May 11, 2007 HUAA Alumni Council Meeting. 

Delegate Information 

Name __________________________________________________________________ 

Position/Title _____________________________________________________________

Daytime Telephone____________________  Evening Telephone ___________________ 

Proxy Information (Must be a HUAA member in good standing)

Name __________________________________________________________________

Address ________________________________________________________________

City ____________________  State __________________  Zip Code _______________

Daytime Telephone___________________  Evening Telephone ____________________

Email __________________________________________________________________

Signature of Delegate _____________________________________________________ 

Date ___________________