Coordinator Form
The FLGenWeb Project, Inc. appreciates your interest in caring for one of our County Sites or Projects.
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complete the form and submit it.
Your form will be reviewed by the
State Coordinator and board for approval.
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Name
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Address
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City
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State
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Zip Code
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Your answer
Email
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Your answer
Alternate Email
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Contact Phone #
*
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Position
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Choose
County Coordinator
Assistant County Coordinator
Special Projects
Other
Birth Month & Birth Day
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Name of County
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USGenWeb Exerience
*
Are you currently serving or have you previously served as a County Coordinator or Assistant County Coordinator in any USGenWeb State Project or Special Project?
Your answer
If so, where and for how long?
Your answer
I understand
*
The FLGenWeb, Inc. is a not-for-profit Florida corporation and as such is required by Florida Statute Title XXXVI Section 617.1601 to maintain a list of members names and addresses.
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Required
Signed ( Type your name in the box below)
*
The FLGenWeb, Inc. is a not-for-profit Florida corporation and as such is required by Florida Statute Title XXXVI Section 617.1601 to maintain a list of members names and addresses.
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Date
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(Transmission of this document to FlGenWeb Project, Inc. is your electronic signature)
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