Laserfiche WebLink
CITY OF MARTINSVILLE INFORMATION FORM <br /> <br /> FOR APPOINTMENT TO CITY BOARDS, COMMISSIONS AND COMMITTEES <br /> ***Please Print or Type All Answers*** <br /> <br /> (If married, please give spouse's first name t) <br /> <br />Residence Street Address <br /> <br />Martinsville, VA 24112 <br /> <br />Mailing Address <br /> <br />City <br /> <br />Zip Code <br /> <br />TELEPHONE NUMBER: Home <br /> <br /> Business. <br />OCCUPATION/EMPLOYER NAME: C,~o <br /> <br />PLEASE PRINT OR TYPE HERE why you would like to be considered for <br />appointment to this co~ittee and what particular qualifications <br />you feel you have: ~ ~ <br /> <br /> (please continue on back) <br />RETURN TO: Clerk of Council, p. O. Drawer 1112, Martinsville, VA <br />24114, NO LATER THAN ~- ~q--O~ . <br /> <br />Date Received (to be completed by Clerk of Council): <br /> <br /> <br />