Congregation Shir Libeynu's Annual General Meeting Date: December 10, 2017


The undersigned, a member of Congregation Shir Libeynu appoints [please check one]:

Chair of the AGM
My personal representative (please list the name of your representative below in the comment section)
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as proxy to vote in the name of the undersigned with all the rights the undersigned would have if personally present, as follows [please mark appropriate line(s)]:
Items Currently on the Agenda
In her or his discretion, upon such other matters as may properly come before this meeting.
Electronic Signature [please type in your name]: 

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