SECOND SCHEDULE

VOTING PAPER

(INSERT NAME OF THE RELEVANT SOCIETY)

VOTING PAPER

NOTES

Note I:

The names of the candidates are given in alphabetical order by province. You may vote only for the candidates nominated for the province in which you are practising.

Note II

There are [•] vacancies as follows:

Note III

You may vote for any number of candidates in your province provided that the number voted for does not exceed the number of vacancies referred to in Note II above.

Note IV

No voting paper other than this will be accepted unless it is sent or delivered by you to the secretary in an envelope marked "Voting Paper" with a letter explaining why the printed form was not returned.

IDENTIFICATION ENVELOPE

Form of Declaration on Identification Envelope

I, (state name)                                                                                                                             who practise at (state address)                                                                                        and name of the firm                                                                                                                       in the province of                                                                                                               being a member of the (insert name of relevant society)                                                                                       do hereby declare that I am the person to whom the enclosed Voting Paper was addressed, that I am entitled to vote and that I have not returned any other voting paper in this election.

Signature of Voter

Signed at                                                 on this             day of                                                   20        in the presence of the undersigned witness.

Signature of Witness