Commission Community Outreach Form

2. Thank you to Councilmembers and Volunteers for serving on Commissions. The Town would never be as wonderful or efficient without your time and talents working towards the betterment of OUR Mount Airy Community!
   Please take a few moments to fill out the form, so that staff can share these important Commission updates with the public to increase public engagement.
4. Name*
5. Email Address*
6. Phone Number*
8. Please select your Commission.*
   -- Select One --BeautificationEconomic DevelopmentRecreation and ParksRecycling and SanitationStreets and RoadsSustainable Mount AiryWater and Sewer
10. List up to two projects that your Commission is working on currently.
12. List up to two opportunities that your Commission has for the general public to get involved. (Commission Vacancy
14. Please explain in up to two sentences what you see the impact these projects/opportunities will have on our Community.
16. Please upload a picture of each Commission member in the file spaces below. PNG or JPEG file formats work best.
18. Commission Member Picture Upload
19. Commission Member Picture Upload
21. Commission Member Picture Upload
22. Commission Member Picture Upload
24. Commission Member Picture Upload
25. Commission Member Picture Upload
27. Commission Member Picture Upload
28. Commission Member Picture Upload
30. Commission Member Picture Upload
31. Commission Member Picture Upload
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field