FAX or POST to: The Internet Society of Australia Attn: Mr Craig Ng Maddocks Level 7 140 William Street MELBOURNE Vic 3000 Facsimile (03) 9288 0666 ______________________________________________________________________ INTERNET SOCIETY OF AUSTRALIA, A CHAPTER OF THE INTERNET SOCIETY ABN 36 076 406 801 PROXY FORM I, the undersigned, being a member of the above Society hereby appoint: of [full name of proxy] [address of proxy] as my proxy to vote for me on my behalf at the Annual General Meeting of the Society to be held at 8:00am on Wednesday 9 December 2009 and at any adjournment of that meeting. If proxy name is blank or if the proxy does not attend, then the chairperson of the meeting is appointed as my proxy. The proxy must vote as specified by me with a mark in the appropriate box. If any of the following resolutions are not specified then voting on that resolution is at the discretion of the proxy. (A) That the annual accounts and reports of the Society are approved: Resolution: [ ] in favour [ ] against [ ] abstain (B) Election of Directors: I wish to vote for 4 (FOUR) ONLY of the following candidates (specified by a mark in the box): [ ] Rob Forsyth [ ] Douglas Ross Kelso [ ] Jeremy Leeson [ ] Skeeve Stevens [ ] Gerald K. White (C) That the Minutes of the AGM held on 19 November 2008 are approved: Resolution: [ ] in favour [ ] against [ ] abstain Signature:_________________________________ Date:____________________ Full name (please print):______________________________________________ ISOC-AU Member #________________________ From your 2009/10 receipt/card (not compulsory) Note: 1. The Proxy Form must be received at the registered office of the Society not less than 24 hours before the meeting, i.e. by 8:00am ADST on 8th December 2009. 2. Do NOT email this form, it must be printed out and sent by post or fax to the registered office of the Society: The Internet Society of Australia Attn: Mr Craig Ng Maddocks Level 7 140 William Street MELBOURNE Vic 3000 FAX: (03) 9288 0666 _________________________________________________________________________