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City of Centerville Citizen of the Year <br /> Nomination Form / rein . <br /> Name of Nominee: (p1 &ei rperi2ratA , Phone: /, 51- 653 07 ?/ <br /> Address: /3 1/41 RP.Voi r fu Ur Jl <br /> Please check and write in the name of organizations, groups, and committees in <br /> which the nominee is actively involved i.e., city council, parks & recreation, planning & <br /> zoning, EDC, Centerville Lions, Centerville Parents Association, Boy & Girl Scouts, Church <br /> committees, School involvement etc. Use "Other" for any not listed. <br /> C� City of Centerville Committee: ❑ Local Organization: <br /> CNN 4- hit & A es <br /> ❑ Local Organization: ri School: `o,-A-crv.'U e <br /> -ac- '.5'01 co l s- tt€9 -I y eccr <br /> Cd _Church: or,Tectther rac{hlair 'G ❑ Other: <br /> (�ornrrttrr.i4+� Oe iui-4ies <br /> ❑ Other: Si Other: Vau ¢.eer <br /> /irw �� pn y 5 /;off S4010 <br /> Please list below the tasks that the nominee has accomplished during this past year <br /> that have been of benefit to Centerville and its residents: t hmee a I n r � lu; 4+, <br /> e)h -ers $orrned CNN & grout) c reskde►,-ks fL\n .t <br /> 1dtsini eh -b ir hpwe. out- eLrnmu . CAIN W w.{l. �kF�e o: t�wr -R�. <br /> _t„__ _ 4 Wring Rear. eree Park 40 a. rQ krna e . 5 e.„..-1- the/oaf Uol r <br /> `'ltofs Worths 301/40ard.t, `Wt. cdcw �S nee fc, ma-k- 'k_ reatl <br /> r . - r as -lh.c SCh fa Casa r c s Cpl:es. t4 0( <br /> taco. rra. c -kv'.? in, 4)4 OE r -1--10 Sitt k.. s ll hie e.ls. J �imee Wancect <br /> 14 du <br /> 51.t6w ring �arnt so.{x. Ja �`� to nnn: 61m-a.,, I, `{'{u- gir is <br /> s tCb % . f rnn'. vo{oml-wrs }tw a � hot .. t 4L eau rck 4A41-‘ yc w; <br /> Are ere any other factors you feel may be important to consider rs• regarding this <br /> nominee betn5 a -Conner- 1Niriner osr -Ws award I. ?ersarL <br /> Arnow Whad'-t l- te.3/4 s io be. bone. rEd RS u Caier.4, a& -IL tear <br /> wrld &lieve- mo . sa. Airnev ha.s 51vet wFlak- t - - L --s <br /> 4 c' n 4er4; (le_ i (g.9Q. Sha, is r+,ore tea. ce-se -ry h5 At +44e, et ;zc ocF <br /> Nominated by 1 \ C u'a— Date 2 /I!; /Rq <br /> Address: () lb r ey, It c, <br /> Phone: 6 61 -- I""133- <br />