Proxy Authorization Form

Please complete the form below to authorize a proxy to represent you at a member business meeting of NAMI PA, Main Line and vote on the Resolution which was attached to the notification of the February 2019 business meeting and is available at https://namimainlinepa.org/wp-content/uploads/2019/01/Resolution.pdf.  You may choose anyone who is over the age of 18 to act as your proxy. For example, you can choose as your proxy one of these members of the Board of Directors: Ingrid Waldron, Kristine Songster, Ivana Anderson, Ellen Berman, Andrea Brooks, Nancy Dever, Sarah Freudberg, Denise Hay, Loran Kundra or Donna Matthews.

Your authorization of this proxy is revocable at will, but only if notice of said revocation is given in writing or by an e-mail that includes your unique identifier number to the Secretary of the Board of Directors of NAMI PA, Main Line. (Sarah Freudberg can be reached at info@NAMIPAMainLine.org or by mail to NAMI PA, Main Line, 320 Woodley Road, Merion Station PA 19066.) If you do not revoke your proxy, your signature and identifier authorizing your Proxy will be valid until the relevant legal questions have been resolved or for a maximum of 11 months, whichever comes first. For a printable version, click here.


Proxy Authorization Form

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