FORM OF APPOINTMENT OF PROXY
for Election of Officers
to SeniorNet Association Inc.
PO Box559 BOOVAL 4304
ABN 95 360 623 241

I, ...............................................................................................................................................
                                                                  (Full name)

of ..............................................................................................................................................
                                                                    (Address)

being a member of SeniorNet Association Inc.

hereby appoint ...........................................................................................................................
                                                                (Full name of proxy)

of ................................................................................................................................................
                                                                        (Address)
being a member of SeniorNet Association Inc* as being my proxy to vote for me on my behalf at
the general meeting of the Association (Annual general meeting or special general meeting as the 
case may be)

To be held on the ........day of ............20..... and at any adjournment of that meeting.

+ My proxy is authorised to vote in favour of / against (tick your choice) the following appointment:

Name of Candidate            Position to be held           In favour                  Against

..............................            .............................            ..............                    ............

............................................................................
    Signature of member appointing proxy

                                                                                                        Date .............................

* NOTE: A proxy vote may not be given to a person who is not a member of SeniorNet Assoc. Inc

+ You may limit ( or not) your proxy to vote for you specify in this manner. Where no limitation is stated, the
    proxy is entitled to vote according to her or his judgement.

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