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?��1!�d�`�f,�1���3� ;��U��� � ���� L7��s�l�����d7�'r+�l. �`i��.i����3��if��-+ie��.l17 <br />��� .���1����� �����, ����������-�r�, �. �. ����� <br />�pLUt1�� f <br />��' ; '�'� �% <br />� m <br />� == .s .` � <br />� :'r;� � �-�..� —1 <br />C'� � 'ti;=� Mq � I➢7 <br />fL >.. Z <br />��6 ;' ';;"�;: � �-�}^�� <br />�' <br />r�T6-19 i 6 <br />�;�����.� � �����:��.. �������������'� ����„�`�=�����'� <br />P�i�C��U�iAt 5icr�S: (Please raad guideiin�zs and definitions first} <br />1. Havethechief elected ofziciai appoint a chairperson and membefs of a Bicentennial Commission ar Gommittes <br />whic� is representative oF all segments in the sommunity. �+II aut Appendix A{page 31. <br />2. Plan an initia! Sice�tennial program. Fi11 outA}�pendix B(page 41. Mark iasting reminders with an "X"_ <br />3. Co;nplete Aart i tbelowj and �art iif (page 2} as weli as Appendices A and S. <br />4. Send campieted application #o the Siate Sicentennial Organization (make a copy for your iiies). • � <br />5. Apprise your tilembers of Congre�ss (�iepresentatives and Senators) that #his application has been submitted. <br />t'ASi7 1 — C��iT��ICAii01� <br />IT 15 CEAT{FIED:' <br />1. That as chair�erson a# i�e special Bicentennial Graup, I am aut�orized to sign this certificatian. <br />2. That a!i the above prQCedura) steps hav� been accorr�plished. <br />3. ihat the undersigned ar my successar, wiii furrrish penodic process repoi-ts when requeste.d: <br />�1. 7hat, if approved, the Uationai Symbal wili }3e used in accordance with the A,�R A Graohfcs :4lanual. � <br />�„�, , � � J1ti�-�`%�--- <br />�_�r��¢�� 5��1 <br />5tgnature of C�►a�r rs�n � � <br />i7 t5 C��T1F1�D: <br />7. That ih�s is our o€fir�al appiication for recognition as a Bicantsnnial Community_ <br />2, Ti3at thEs e€fort will have broad basec! community support. <br />3. Tha�: availabfe community resources wiil be utilized in the implementation of this effort, <br />(Aff1x official seal irt thia space) <br />��Ri I1 —��oR ST�4T� a�r,EV'�Eli��AL U�� O�1LY) <br />Official Nama of 5tate Sicentennial Organization <br />CY;airrnan <br />Sent to Regiona4 OFfi <br />GGP�7 M =N-ia : <br />Signature of Chief El�cted Dificial <br />DateA�pi�cation Received <br />Anproved <br />iit <br />(signature nf authorizad officer) <br />;af authorized officer) <br />