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Legislative Representative Form

DESIGNATION OF 2018-2019 FSBA LEGISLATIVE COMMITTEE REPRESENTATIVE

Please complete the online form below and submit the form by July 2, 2018. If you have any questions or concerns, please contact Ruth Melton by phone at 850-414-2578 or by email at melton@fsba.org.

This form is also available in Word and PDF formats.

School District:

Legislative Representative:

Address (Full):

Cell Phone:

Email:

Other contact information:

___________________________________________________________

Alternate:

Address (Full):

Cell Phone:

Email:

Other contact information:

___________________________________________________________

Name of person completing this form:

Position:

Phone:

Email:

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Phone: (850) 414-2578
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