An instrument appointing a proxy shall be in the following form or a form as near thereto as circumstances admit (or in any other form which the directors may accept) and shall be signed by the appointor or his attorney duly authorised in writing, or, if the appointor is an incorporated body, shall either be given under its common seal or signed by an officer or attorney duly authorised:—

Where it is desired to afford members an opportunity of instructing the proxy how he shall act, the following words (or words as near thereto as circumstances allow) shall be added to the instrument between the space provided for details of the policy or policies and the space provided for the date of signing:—