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2. Current Board and Committee Vacancies

4. Filling out of this form in no way assures appointment. All vacancies will be filled by citizens deemed most qualified to serve in each capacity.

   
   

6. First Name*
7. Last Name*
9. Address*
11. Phone Number*
12. Business Number
14. Email Address*
16. Amount of Time Available
18. Interested in What Town Committees:
20. Present Business Affiliation and Work:
22. Business Experience:
24. Education or Special Training:
26. POSITIONS HELD
28. Town Office
29. Date Appointed
    Date Appointed
30. Term Expired
    Term Expired
32. Town Office
33. Date Appointed
    Date Appointed
34. Term Expired
    Term Expired
36. Town Office
37. Date Appointed
    Date Appointed
38. Term Expired
    Term Expired
40. Remarks
42. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
44. Electronic Signature*
45. Date*
    Date
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field