Proxy Vote Form printable pdf download

Voting by Proxy as per SCOA Codified Policy

At all meetings of the Association, a member or members may vote or otherwise act by proxy.

A member may only cast two votes, one for himself, and one proxy. For the proxy to be valid,

the member or the member’s duly authorized attorney-in-fact must execute such Proxy Form as

may be approved by the Association’s Board of Directors for such purpose. The Proxy Form

shall be dated and shall be effective as of the date it is filed with the Association’s Election Chair

or other person authorized by the Association to tabulate votes before or at the time of the

meeting. Unless otherwise expressly stated on the Proxy Form, the proxy shall remain valid for

one month. In no event shall a proxy be valid for more than one year from the date of its

execution. The proxy is revocable by the person appointing the proxy either by attending any

meeting and voting in person or by signing and delivering to the secretary or other officer of

OARD OF

IRECTORS

agent authorized to tabulate proxy votes either a writing stating the appointment of the proxy is

Edward Lemon, O.D.

revoked or a subsequent appointment form. Subject to South Carolina law or express limitation

President

appearing on the Proxy Form, the Association shall accept the proxy’s vote or other action as

James M. Vaught, O.D.

that of the member making the appointment.

President-Elect

Lori R. Donovan, O.D.

Vice-President

Completed form can be faxed to the SOCA Office at 803-799-1064.

Michelle Cooper, O.D.

Secretary/Treasurer

Peter V. Candela, O.D.

SCOA P

ROXY

ORM

Immediate Past President

IRECTORS

Phyllip Flynn, IV, O.D.

I, _________________________________, as member in good standing of the South

Benjamin Ingram, O.D.

Carolina Optometric Association, appoint _____________________________, whose address

Melissa Schwebach, O.D.

is _________________________________________________________, to vote as my proxy

Sean M. Stevens, O.D.

at any and all meetings, regular or special, of the members of the corporation, or any

adjournments that may be held during the period of this appointment. The duration of this proxy

shall begin as of the date it is signed by me and shall extend through __________________. I

grant to my proxy all the powers I would possess if I were personally present at SCOA

members’ meetings, with the exception of the right

to_________________________________________ (please mark “not applicable” if unlimited

rights are granted). This proxy shall be ineffective for purposes of any meeting that I personally

attend.

2730 Devine Street

Columbia

I hereby revoke all proxies I have previously made. I reserve the right to revoke this

South Carolina

proxy at any time by filing with the SCOA Office or election committee or other person

29205

authorized to tabulate proxy votes either a written notice of revocation or a subsequent Proxy

803-799-6721

Form I have signed.

Fax 803-799-1064

Date: ___________________

Signature: _____________________________

Proxy Vote Form

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