Laserfiche WebLink
<br /> <br />Martinsville <br /> <br />A CITY WITHOUT LIMITS <br /> <br />Online Committee Volunteer Recruitment Form <br /> <br />Thank you for volunteering to serve on a Martinsville City Council-appointed board. The <br />information you submit is used only for council's deliberations in making selections <br />for service. A staff member will contact you if more information is required. If you have trouble e- <br />mailing form, print and mail to: City Clerk, P.O. Box 1112, Martinsville, VA 24112. <br /> <br />First Name IDennis <br /> <br />Middle Name IAlan <br /> <br />Last Name Icasey <br /> <br />About You <br /> <br />Home Address 1713 Windsor Lane <br /> <br />ZIP Code 124112 <br /> <br />Job Title IDirector of Education6 <br /> <br />Preferred Mailing Address I(same) <br /> <br />Home Phone 1632-8306 <br /> <br />Spouse Name IRhonda <br /> <br />Employer IVirginia Museum of Natural History <br /> <br />Preferred Phone for Contact I(same) <br /> <br />Fax Number <br /> <br />E-mail AddressldacaSey@adeIPhia.net <br /> <br />About Your Service <br /> <br />First Preference of Committee ISchool Board <br /> <br />Second Choice <br /> <br />Reason you would like to serve, including any special skills, qualifications, <br />certifications or interests which would qualify you to serve. <br /> <br />Reason for <br />Service <br /> <br />(see attachment) <br /> <br />1~'''"'''rDmb--~1P- <br />~s,~.ql?J1iJ!" .~,~IIA~. . ' . <br /> <br />Rec(j ~/~/Ob <br />