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2. Are you interested in being apart of a Madison Heights Employee Committee?
4. Name*
6. Please pick your first choice *

   1. Wellness Committee
   2. Activity Committee
8. Are you interested in the other committee, if your first choice fills up?

   1. Yes
   2. No
10. What makes you want to join?
12. Please list the best way to contact you below
14. Thank you for all that you do for the City of Madison Heights!
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16. 1. Receive an email copy of this form.
17. Email address

    This field is not part of the form submission.

18. Submit

* indicates a required field