I certify that the information provided herein are true and correct which may be validated by the association. I declare that these are voluntarily given by me for the exclusive use of the SESLA for the purpose of processing my proxy declaration to the association. I agree that the association may store my information until such time that I cease to be a member thereof which may be brought about by expulsion, resignation or death. I further give my consent to the sharing of the above information by the association to any of its affiliates, agents, representatives or assigns but only with respect to the furtherance of my membership in the said association. Other than that, the association must first obtain my consent before sharing my information to anybody else. I will abide by the rules of SESLA.