Board Meeting Agenda Item Request Form
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Board Meeting Date
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Day
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Requested By
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First Name
Last Name
E-mail
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Item Type
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Resolution
Variance or Hearing
Other
Description & Rationale
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Type of Resolution
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New
Renewal
Amendment
Describe
Contract
Agreement
MOU/MOA
Is this a Revenue or Expense?
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Revenue to FCPH
Expense to FCPH
Other
Amount of Revenue or Expense?
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In U.S. dollars
Is the contract generated by FCPH?
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Yes
No
Contact Name
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First Name
Last Name
Contact Address
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Street Address
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Recommendation
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Additional Information
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