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City of Centerville Business Person of the Year <br /> omination Form (C1 C A . <br /> Name of Nominee: / 0hl /22 km Phone: <br /> l - <br /> Address: �/ o Zv'f <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 /> 1 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: , X Local Organization: c. <br /> ❑ Local Organization: X School: . tar( <br /> J?d i !' /l th h ( ❑ Church: ❑ Other: <br /> ❑ Other: ❑ Other: <br /> Please list below the tasks that the nominee has accomplished during this past year <br /> that hambeen •f benefit to Centerville and its residents: <br /> s i U / d / �M s % <br /> P Al its/ 'tl , <br /> Are there any other factors you feel may be important to consider regarding this <br /> nominee <br /> Nominated by k7 Ces et Date cA "1 "00 <br /> Address: " Ja I 4 e bit CP Af5' /i //c <br /> Phone: td / " 65 5 5 -- Slag <br />