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Cemetery Advisory Committee Application

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Chesterfield Cemetery Advisory Committee Citizens interested in seeking appointment to the Chesterfield Cemetery Advisory Committee are asked to complete this form.

Name Date Address Phone Number Cell Phone Number Email Address How long have you lived in Centreville?

1.) Why are you interested in a position on the Chesterfield Cemetery Advisory Committee?

2.) Have you served on other municipal or county boards and / or commissions? Describe:

3.) What, in your opinion, would constitute a conflict of interest for an individual in public service?

Membership Questionaire-Cemetery Advisory Committee

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