| “Each
undersigned, as a member of Chimorel Services
Inc, hereby appoints the Executive Director or
his/her designee the proxy and attorney of the
undersigned, with full power of substitution to
attend all meetings of members and to vote for
me in my place and stead upon all matters properly
coming before such meetings. The undersigned hereby
ratifies and confirms all that said proxy and
attorney may do by virtue hereof. The undersigned
hereby reserves the right to revoke this proxy
at any one or more meetings by attending and voting
in writing at such meeting or meetings. This proxy
will remain in effect for all meetings which the
undersigned does not attend and vote in writing,
except that returning a ballot by mail/email shall
also constitute revocation of this proxy for and
only for the meeting for which said ballot is
returned.”
Your
signature(s) & date below accepts the terms
and conditions for the membership and program(s)
you have applied for as described under Chimorel’s
Programs.
Signed
1 ___________________________________ Signed 2
______________________________________ Date ___/___/12
Please return to Chimorel Services Inc,
PO Box 340502, Worthington, OH 43234.
Your typed name and date can substitute
for your signature, if you return the application
by email.
|
|
