IGBO Mid-year 2020, Zoom

Welcome to the IGBO Proxy. A league or tournament may be represented at a General Membership Meeting by proxy if neither the representative nor the alternate representative can be present. To designate a proxy holder, submit this form prior to the start of the General Membership Meeting. To be valid, this form must be received no later than 8AM EST, Friday November 13, 2020. After you SUBMIT the form a confirmation email will be sent to the email address provided. Please review this for accuracy. If you find any typos or corrections, please email Secretary@IGBO.org.

Type of Member*

League

Tournament

Member Name*

Enter your League or Tournament Name

Location *

City*

ST / PR*

Country*

(US / CA / AU / NZ / DE / GB)

IGBO Region*

Person authorizing Proxy Form *

Name*

First

Last

Phone No.*

Email *

The confirmation email will be sent to this Email Address

Enter Email*

Designating a Proxy

To name a specific individual to represent your league / tournament at the GMM, enter the name below. A person can represent only three (3) members at a meeting. Please verify that this individual is able to represent your league/tournament before putting their name on this form. If you leave this field blank, a member of the Board will find a Proxy Designee on your behalf.

Person accepting your proxy

First

Last

IGBO Attestation for e-Signature

By checking the box below I certify that I am the person named above and that I am authorized to act on behalf of the named league/tournament

e-Signature Agreement *

I acknowledge that I have read and agree with the Attestation for e-Signature

Are you human?*

This field should be left blank