RIPE NCC General Meeting October 2006 Proxy Registration Form

If you are unable to attend this RIPE NCC General Meeting in person, and would like to use your RIPE NCC LIR member vote, you may nominate a proxy voter to attend instead.

To do this please print, fill in the form below and fax it to +31 (0) 20 535 4445

If there is time to allow for delivery, you can also send your form by post to:

RIPE NCC
P.O.Box 10096
1001 EB Amsterdam
The Netherlands

More information on proxy voting is available in the RIPE NCC Articles of Association.

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On behalf of the RIPE NCC Member _____________________________(company)

with LIR Reg-ID  ______________________________________________________

I am pleased to inform you that we will be represented by 

Mr./Ms.  _______________________________________________________(name)

Date of Birth ___________________________________________(for ID check)

at the RIPE NCC General Meeting on 5 October 2006. 

The above person is authorised to represent our company in this matter.

Registered LIR contact: 

Note: this will be matched with your company’s information in the RIPE NCC Database

Signed _________________________ Print name ______________________

Job Title ____________________________ Date _______________________

Proxy voter: 

Signed _________________________ Print name ­­_­­______________________

Job Title ____________________________ Date _______________________

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