U.S. Complete Shooting Dog Association
2015 Proxy Form
Be it known that __________________________, the undersigned member and officer of the ______________________________________________________________________
Herby constitute and appoint __________________________ as my true and lawful agent to vote as my proxy
regarding any and all issues to be discussed at the U.S. Complete Shooting Dog Association Annual Meeting held in
_Newton, VA___ on July 18, 2015.  I herewith revoke any other proxy heretofore given.

Witness my hand this _________ day of _____________, 2015.

Signed by ____________________________, _____________
                                   (Signature)                                   (Title)
of __________________________________
                            (Name of Club)