Contact Update Form

Questions? contact consortium@tompkins-co.org
Person completing form:field type single line
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Emailfield type email
Municipalityfield type single line
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This update is for:field type drop-down
Name of former contact or memberfield type single line
who is being replaced?
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Name of new contact or member:field type single line
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Title of new contact or member:field type single line
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Email address of new contact or member:field type email
Phone number of new contact or member?field type single line
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Effective datefield type date

Board of Directors and Joint Committee Appointments:

Date of appointment by municipalityfield type date
upload or attach a copy of appointment by Municipality (Resolutions, Minutes or Correspondence from Chief Elected Official)
Upload documentationfield type file upload
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