Coordinator Form
The FLGenWeb Project, Inc. appreciates your interest in caring for one of our County Sites or Projects.
Please
complete the form and submit it.
Your form will be reviewed by the
State Coordinator and board for approval.
Thank You for your interest.
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Name
*
Your answer
Address
*
Your answer
City
*
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State
*
Your answer
Zip Code
*
Your answer
Email
*
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
*
Your answer
Name of County
*
Your answer
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.
Yes
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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