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City of Centerville Business Person of the Year <br /> Nomination Form ;Of1 <br /> Name of Nominee: 16yd br.1/ j, hit inc... Phone: go— 823—a <br /> Address: Mona d T.; <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 /> EoV Pt <br /> Local Organization: ❑ School: <br /> ❑ Church: ❑ Other: <br /> ❑ Other: ❑ Other: <br /> Please list below the tasks that the nominee has accomplished during tl 's bast ear <br /> that have been of benefit to Centerville and its residents: P g <br /> , <br /> _. ,� � , � � N � c <br /> A Ar a traffSrAJW: // <br /> a ._, �.. ( 'S <br /> Are there any other factors you feel may be important to consider regarding this <br /> nominee <br /> Nominated by j ,,, —. 4 / Date _2IZS /oa <br /> Address: , /da <br /> Phone: <br />