LOUISIANA WILDLIFE FEDERATION, INC.

Date

Board of Directors Meeting

PROXY

I, the undersigned duly elected/appointed member of the board of directors of the Louisiana Wildlife Federation (LWF), hereby appoint (name of substitute) as proxy with power of substitution for me, and in my name to vote with all powers that I shall possess if personally present at the (Date) meeting of the LWF board of directors.

(Select One below)

As an LWF director representing an affiliate, I certify that the above-named substitute is a member in good standing of said affiliate OR a qualified fellow LWF director.

As an LWF board member serving as a district at-large director, at-large state director or past president, I certify that the above named substitute is a qualified fellow director to represent me in this capacity.

* No director/substitute can represent more than two votes at any meeting.

Signed Date:

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Proxy Form for BOD Meeting

LOUISIANA WILDLIFE FEDERATION, INC.

Board of Directors Meeting

PROXY

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