A.B., , a member of the Senate, doth hereby appoint C.D., , a member of the Senate, to be the proxy of the said A.B. in his absence, and to vote in his name at the election of a Chancellor, or High Steward, as the case may be, for the University of Cambridge, on the day of next, in such manner as he the said C.D. may think proper. In witness whereof the said A.B. hath hereunto set his hand, the day of .
(Signature) A.B.