Name *

First Name

Last Name

Title *

Board President

Board V. President

Board Treasurer

Board Secretary

Board Director

Other

Tel # where you may be reached *

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###

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Community Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Projected start date

Is there a projected date in which the BOD is expecting the new management company to begin their services?

MM

DD

YYYY