FORM OF APPOINTMENT OF PROXY for AGENDA item
SeniorNet Association Inc.
PO Box 559 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 my proxy to vote for me on my behalf at the
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 (delete as appropriate) the following
proposal ( insert details). If there is an Agenda item no., please quote it. Otherwise please
give the wording of the proposal.
                                                      Agenda item no:  ...........
Wording of proposal:





......................................................................
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 as you specify in this manner. Where no limitation
    is stated, the proxy is entitled to vote according to her or his judge.

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