NOMINATION FOR MAYOR’S COMMITTEE MEMBER OF THE YEAR – City of Goldsboro

NOMINATION FOR MAYOR’S COMMITTEE MEMBER OF THE YEARLaToya Henry2023-10-25T16:40:57-04:00

NOMINATION FOR MAYOR’S COMMITTEE MEMBER OF THE YEAR

A member of the Mayor’s Committee who has done much to further the work of the committee during the year.

Deadline: Wednesday, November 15, 2023 by 5:00 p.m.

1. Nominee's Name:
2. Home Address:
Street Address Address Line 2 City State ZIP Code
3. Business Address:
Street Address Address Line 2 City State ZIP Code
4. Home Phone
5. Business Phone
6. Name of Employer:
7. Nominee's Job Title:
8. Briefly describe significant contributions made to enhance the quality of ife for disabled persons and to promote public awareness and understanding relative to their plights.
Submitted by:
Date
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