Civic Association Contact Information Form

Legal name of association/civic group:   

Name of point of contact:

First Name:  Middle Initial:
Last Name:


Suite/Apt #:
City:   State:  Zip:

Home Phone:
Office Phone:
Other Phone: Type:

E-mail address:

Please provide your meeting schedule or any additional pertinent information:

this Contact Form

this form and start again.

As with all correspondence received by the Board of Supervisors, the content of your message, including your name, address, phone numbers and E-Mail address, are subject to disclosure under the provisions of the Virginia Freedom of Information Act, and if requested must be provided.

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