2020 NAACCR Business Meeting Voting Proxy

The NAACCR Business Meeting will take place virtually for 2020. If you are unable to attend and vote electronically via a smart phone with text or the ability to download our voting application then please assign a representative from your organization who will be attending the meeting to vote on your behalf. A proxy delegate must be designated in advance to vote on behalf of the member organization. If the voting delegate will not be able to attend the annual business meeting of NAACCR a proxy delegate can be designated to vote on behalf of the member organization.

The proxy request must be submitted to the NAACCR Executive Office within the established deadline.
The proxy delegate must:
a. be registered with the NAACCR office as a member of the NAACCR member organization
b. be present at the NAACCR business meeting.

The assignment of a proxy will be in effect for this 2020 Business Meeting only. To permanently re-assign the Voting Delegate for your organization please contact the NAACCR office at 217-698-0800 to request the change.

1. Name of Member Organization: *This question is required.

2. Voting Member on Record

Full Name *This question is required.

Email *This question is required.

Phone Number *This question is required.

3. Change to Proxy Voting Member

Full Name *This question is required.

Email *This question is required.

Phone Number *This question is required.

4. Date of Submission *This question is required.

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5. By clicking YES below a new field will pop up. Please insert your full name in the box that will appear below after you check YES. This will certify that you are the NAACCR Voting Member on record for your organization and have the authority to assign voting privileges to the individual listed as the voting proxy. *This question is required.

Insert Full Name of Voting Delegate on Record *This question is required.