Congregational Meeting Proxy Form

Members: If you are not able to join us for our special Congregational Meeting, Thursday November 5, 2020 at 6:30 PM, please fill out this form to assign your proxy.

If you assign your proxy to anyone other than Peter Mackler, please note that they must be present at the virtual meeting, and be a member in good standing to vote on your behalf.
Individual members are able to hold two (2) proxies.

* First Name

* Last Name

* Email

* Mobile Phone

Proxy Assignment

Peter Mackler, Secretary/Acting ChairOther (Please Indicate)

Name of Proxy

Please take note of restrictions above for proxies other than Peter Mackler.

* Digital Signature Acknowledgement

Digital Signature AcknowledgementAs a voting member of Congregation Kol Ami, I appoint Peter Mackler, Secretary / Acting Chair (or alternately, the person indicated above) as my proxy to vote on the items contained in the agenda. Checking this box affirms my signature on this proxy form.

Sun, September 14 2025
21 Elul 5785

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Sun, September 14 2025 21 Elul 5785