Lesley Zerebny Park form

NAMING OF DISTRICT FACILITIES SUGGESTION FORM “Exchange Club Park” Project in Valle Vista Lesley Zerebny Memorial Park Name for Consideration: __________________________________________________________  All fully completed forms will be reviewed by the Valley-Wide Board of Directors and considered in determining the facility name.  The Facility may be named after the region and/or individual or individuals who have been instrumental in the community. Description of the significance and/or reason for the name consideration: (Please print or type comments. No cursive) ________________________________________________________________________________________ For bravely continuing the legacy of Public Service, by committing herself to the honorable profession of Law ________________________________________________________________________________________ Enforcement, who lost her life while servicing the community she was sworn to protect. ________________________________________________________________________________________ End of Watch, Ocotober 8th 2016, armed with the sword of her spirit. May the park serve as an everlasting ________________________________________________________________________________________ memory of her dedication, a tribute to all that have served, and an inspiration for others to follow. ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Submitted By: Name (please print) _____________________________________________________________________________ Address ___________________________________________________________________________________________ Phone Number: _____________________________ Email: _____________________________________________ Signature: ________________________________________________ Date: _________________________________ PLEASE SUBMIT COMPLETED FORMS TO THE VALLE VISTA COMMUNITY CENTER (43935 E. ACACIA AVE. HEMET, CA 92544) ) NO LATER THAN OCTOBER 14. 2016.