SIPP SCHEDULE A DESIGNATE FORM

SCHEDULE A

DESIGNATE FORM

This form allows a Member of the South Island Prosperity Project (“SIPP”) to appoint an individual (a “Designate”) to vote on their behalf at the SIPP Annual General Meeting (AGM).

I hereby authorize __________________________ to serve as my Designate and to vote on my behalf on all matters voted on at the AGM of the South Island Prosperity Project to be held on June 27, 2019.


Name of Member:
Member Organization:
Address:
Signature:
Date:

Submit completed form to:

South Island Prosperity Project 901-747 Fort Street Victoria, BC, V8W 3E9