Proposal for New Stadium Ref: COMM/PRO/001

Issue: 0.22A
Building Date: 07/08/09
Page: 1 of 1

Meeting Acceptance Form

Re: New Stadium Building in Newburgh telephone survey

The Newburgh Sports Development Committee kindly requests you to
provide the following information, by June 20th at the latest:

I am willing to take part in this survey No

Please add me to the mailing list

My details for mailing are as below:

Name:      

Address:      

Phone (Home):      

Mobile:      

Email: