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Soil Conservation District Reorganization Form
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Soil Conservation District Name:Year:
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Mailing Address:Area:
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City, State, Zip Code:
Office Phone:
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Supervisor InformationThe information below will ONLY be used for emergency purposes.
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Elected Supervisor NameAddressCity, State, Zip Code
Phone Number
Email Address
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Appointed Supervisor NameDate AppointedAddressCity, State, Zip Code
Phone Number
Email Address
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* Please denote board chair using an asterisk (*) after their name
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District Staff InformationDistrict Staff Alternate Information
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Employee NameTitleOffice AddressCity, State, Zip Code
Phone Number
Email AddressEmployee Name
Alternate Phone Number
Alternate Email Address
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Extension Agent
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Conservationist
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