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4 <br /> k <br /> City of Centerville Business Person of the Year <br /> Nomination Form ie\CAO\ . <br /> Name of // Noomineet f a r� ,ems 4l /e rZ Phone: h.53 - 2S <br /> Address: Q,4tr 4;5(1 3 / 34 0- 7 1975 g d ,� - 45 p f%10 <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 /> • City of Centerville Committee: ❑ Local Organization: <br /> Fce OF.S L4cS <br /> • ;peal Organization: ❑ School: <br /> (.ndl �-/ 0n6 <br /> ❑ Church: ❑ Other: <br /> ❑ Other: ❑ Other: <br /> Please list below the tasks that the nominee has accomplish d during this year <br /> that have been of benefit to Centerville and its residents: (t . (` Q <br /> i 1t Ac:! ei:a_.. �_ _ • 11 _ At.;t II; - <br /> a _ €,.•_ °tea; - _ : • " <br /> <`� t Le fel'Ltti riAn cw--) �?- %61.7fr SA. (e 3o a se <br /> l • .. _ Ass. - A • i a_ _v'ti . 41' _a L . J <br /> ,. _i _ _ - : _ ' � a jL C ny <br /> (,-' /2J JC.,h ncC•' t.D &J--- • r/ J4- 4 O.lac -P1 <br /> Gn a. -ttie [.e w- &Lodi /LAM- CP cm�.p t Bccit 11 <br /> Are there any other factors you feel may be itnportant to consider regarding this (b <br /> nominee <br /> byitAjAkit cit i Date J - 9 — 7000 <br /> Address: 1544/ Z l` c 57: <br /> Phone: (053' () qi ( <br />