Yates County Republican Party Meeting Proxy Form

  I ________________________________(print name) am unable

to   attend the Yates County Republican Committee meeting

  on ____________________(date).   I do here by designate

  ________________________________(print name), a registered

   Republican of my Town to act on my behalf.

Signature: _______________________________  

Print name: _____________________________   _

Print out this blank proxy form, fill in all the blanks and bring it to meeting.  Give it to YCRC Secretary when requested.