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Lee County Medical Society Alliance Foundation

MINI-GRANT REQUEST

BOARD COMMENT FORM

Discussion on the recommendation for Mini-Grant requests is limited to the board meeting. Your cooperation in not discussing this information outside of that meeting would be greatly appreciated. In the event you will not be able to attend the meeting or would prefer to write your comments, this form has been provided and should be returned to Mini-Grant Chair by mail, fax or hand delivery at least one (1) day prior to the Board Meeting.

__________ I agree with the recommendations of the Mini-Grant Committee as presented.

__________ I agree with the recommendations of the Mini-Grant Committee with the exception of the following: ___________________________________________

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__________ I disagree with the recommendations of the Mini-Grant Committee for the

following reasons: _________________________________________________

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__________ I have the following concerns and/or comments: __________________________

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I understand this form is for discussion purposes only and is NOT to be considered a PROXY VOTE.

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Signature (Required) Date

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Print Name Position

 

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                 Copyright © 1998 Lee County Medical Society Alliance, Inc.  All rights reserved.
              13300-56 S. Cleveland Ave #112
            Ft. Myers, Florida 33907
           Phone: 239-936-1645

           Revised: June 08, 2002.